Nicosia General Hospital cardiac arrest team: first year's practice and outcomes of in-hospital resuscitation.
BACKGROUND
In 2007, Nicosia General Hospital implemented a resuscitation policy. 378 nurses and 120 doctors were successfully trained in advanced life support (ALS) in order to staff cardiac arrest teams. The aim of this study was to assess the frequency of cardiac arrest and resuscitation outcomes in Nicosia General Hospital and assess any associations between the survival rate and the patient's characteristics. We also aimed to evaluate the effectiveness of in-hospital resuscitation in order to detect ways of improvement.


METHODS
We prospectively analyzed the data on all cardiac arrest calls in Nicosia General Hospital between January and December 2007. Data were collected using the Utstein style.


RESULTS
The cardiac arrest team (CAT) was called 83 times, of which 10 were false alarms. Cardiac arrest was identified in 69 calls, while 4 calls were respiratory arrests. The patients' mean age was 70.8 years (95% CI: 66.6-75.1). In 86% the initial rhythm was asystole/pulseless electrical activity (PEA) and in 14% ventricular fibrillation/tachycardia (VF/VT). Return of spontaneous circulation was achieved in 52% of the cases. Survival to discharge was achieved in 17.8% of the patients with arrest and in 14.5% of cardiac arrests. Patients with an initial rhythm of asystole/PEA were discharged in 5% and patients with VF/VT in 70% of cases. About 36% of the patients less than 60 years old and 12% of the patients older than 60 were discharged. The CAT arrived within 1.6 minutes, first shock in VF/VT was delivered within 1.5 minutes and the first adrenaline dose in asystole/PEA was given within 2.7 minutes.


CONCLUSIONS
It is more likely for our patients to survive to discharge if they are less than 60 years old, they are hospitalized in the cardiology department and the initial rhythm is VF/VT. Our outcomes are similar to survival rates in larger studies. However, points of improvement have been identified and interventions need to be made in order to improve documentation and outcomes of in-hospital arrests.
Eftychiou
Christos
C
Cardiology Department, Cyprus. chiou6christos@yahoo.com
Georgiou
Marios
M
Andreou
Andreas
A
Michaelides
Andreas
A
Yiangou
Kyriakos
K
Deligeorgis
Alexandros
A
Petrou
Petros
P
Georgiou
Panayiota
P
Christodoulides
Theodoros
T
Makri
Loukia
L
Georgiou
Evanthia
E
Patsia
Thalia
T
Nicolaides
Evagoras
E
Minas
Michalis
M
D000368:Aged; D003535:Cyprus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality / Q000639:trends; D057209:Hospital Rapid Response Team / Q000706:statistics & numerical data* / Q000639:trends; D006769:Hospitals, General; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010351:Patient Discharge / Q000706:statistics & numerical data; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D014218:Triage