title: Causes of in-hospital cardiac arrest and influence on outcome.
abstract: OBJECTIVE
  To evaluate the relationship between cause and outcome of in-hospital cardiac arrest.
  
  
  METHODS
  Retrospective analysis of resuscitation data, causes of cardiac arrest and outcome with a follow-up to 6 months of a cardiac arrest registry in an emergency department of a tertiary care hospital, covering a 17.5-year period.
  
  
  RESULTS
  Of 1041 patients, 653 were male (63%), the median age was 64 years (IQR 53-73), 51% suffered cardiac arrest in the emergency department. The first recorded rhythm showed PEA in 432 (41%), ventricular fibrillation in 404 (39%) and asystole in 205 (20%) patients. Cardiac arrest of cardiac origin occurred in 63% of all patients, with 35% of them due to acute myocardial infarction. Non-cardiac causes were mostly due to pulmonary causes (15% of all patients). Aortic dissection/rupture, exsanguination, intoxication and adverse drug reactions, metabolic, cerebral, sepsis and accidental hypothermia each ranged between 1 and 4% of the cohort. Of all patients, 376 (36%) were discharged in good neurologic condition. Overall, patients with cardiac causes had a significantly better outcome than those with non-cardiac causes (44% vs. 23%, p<0.01). Patients with pulmonary causes survived in 24%. The other subgroups showed widely divergent survival results (3-65%). Patients who had suffered cardiac arrest in the emergency department had a better outcome then patients of the regular ward or radiology department.
  
  
  CONCLUSIONS
  In hospital cardiac arrest is caused mainly by cardiac and pulmonary causes, outcome depends on the cause, with a big variability.
authors.affiliation: Department of Emergency Medicine, General Hospital of Vienna, Medical University of Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Wallmuller
authors.forename: Giora
authors.initials: G
authors.lastname: Meron
authors.forename: Istepan
authors.initials: I
authors.lastname: Kurkciyan
authors.forename: Andreas
authors.initials: A
authors.lastname: Schober
authors.forename: Peter
authors.initials: P
authors.lastname: Stratil
authors.forename: Fritz
authors.initials: F
authors.lastname: Sterz
mesh_terms: D000368:Aged; D005260:Female; D006323:Heart Arrest / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012151:Resuscitation; D012189:Retrospective Studies; D016896:Treatment Outcome