Is ward experience in resuscitation effort related to the prognosis of unexpected cardiac arrest?
BACKGROUND
The aim of this study was to investigate the outcome of patients of unexpected cardiac arrest initially resuscitated by first responders with dissimilar experiences under the support of cardiac arrest team (CAT).


METHODS
All unexpected cardiac arrest patients receiving in-hospital resuscitation with the activation of CAT in a tertiary-care teaching hospital over a 12-month period were recorded according to the Utstein criteria. We prospectively recorded various factors at resuscitation and retrospectively evaluated the outcome. Outcome measures included return of spontaneous circulation (ROSC), survival longer than 24 hours, and survival to discharge.


RESULTS
Altogether, 76 emergency calls were registered, and among these, 44 calls (58%) were cardiac arrests, including 8 ventricular tachycardia/fibrillation, 15 pulseless electrical activity, and 21 asystole. The rate of ROSC was 61%, the rate of survival longer than 24 hours was 37%, and the rate of survival to discharge was 18%. The response time of our CAT was 271 seconds (4 minutes and 31 seconds) on average. The patients who collapsed in the wards experienced in resuscitation effort received higher rates of appropriate basic and advanced cardiac life support interventions before CAT arrival (79% vs. 44%; p = 0.019), had an increased chance of ROSC (75% vs. 38%; p = 0.014), survival longer than 24 hours (54% vs. 13%; p = 0.007), and survival to discharge (29% vs. 0%; p = 0.036).


CONCLUSIONS
Hospital wards with more than 5 cardiac arrests per year have a better patient survival rate than those with fewer arrests. This is despite all ward staff receiving the same level of training.
Hou
Sen-Kuang
SK
Emergency Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Chern
Chii-Hwa
CH
How
Chorng-Kuang
CK
Wang
Lee-Min
LM
Huang
Chun-I
CI
Lee
Chen-Hsen
CH
D000368:Aged; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000401:mortality*; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D011379:Prognosis; D012044:Regression Analysis; D015996:Survival Rate