Who survives cardiac arrest in the intensive care units?
OBJECTIVE
The aim of this study was to evaluate the factors related to outcome regarding in-intensive care unit (ICU) cardiac arrest (IICA) in a university hospital.


METHODS
Adult nontraumatic ICU patients who sustained IICA were prospectively enrolled. Several patient and event-related variables, as well as outcomes, were recorded and summarized based on the revised Utstein-style template.


RESULTS
A total of 202 episodes of IICA happened during the study period. Return of spontaneous circulation (ROSC) was achieved in 127 patients (62.9%), whereas the overall survival-to-discharge rate was 15.3% (31 patients). In univariate analysis, a shorter duration of resuscitation and pulseless ventricular tachycardia/ventricular fibrillation (VT/VF) as initial arrest rhythm represented better outcomes. Independent predictors of survival to hospital discharge were VT/VF as the initial rhythm (odds ratio [OR], 3.81; 95% confidence interval [CI], 1.50-9.67; P = .005), lower Acute Physiology and Chronic Health Evaluation II score (OR 0.92, 95% CI 0.87-0.98, P = .008), and shorter resuscitation durations (OR 0.91, 95% CI 0.87-0.96, P < .001).


CONCLUSIONS
Shorter resuscitation duration and initial VT/VF are predictors for both ROSC and hospital survival, whereas lower Acute Physiology and Chronic Health Evaluation II scores predict the latter.
Chang
Shih-Heng
SH
Department of Emergency Medicine, National Taiwan University Hospital Yun-Lin Branch, Douliou, Taipei 100, Taiwan.
Huang
Chien-Hua
CH
Shih
Chung-Liang
CL
Lee
Chien-Chang
CC
Chang
Wei-Tien
WT
Chen
Yu-Tsung
YT
Lee
Chiao-Hao
CH
Lin
Zhi-Yi
ZY
Tsai
Min-Shan
MS
Hsu
Chiung-Yuan
CY
Ma
Matthew Huei-Ming
MH
Chen
Shyr-Chyr
SC
Chen
Wen-Jone
WJ
D018806:APACHE; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006323:Heart Arrest / Q000401:mortality*; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D017180:Tachycardia, Ventricular / Q000401:mortality; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000401:mortality