title: The epidemiology of respiratory arrests in a teaching hospital.
abstract: OBJECTIVE
  We aimed to characterise antecedent causes and outcomes of respiratory arrests occurring within a metropolitan tertiary teaching hospital in Melbourne, Australia.
  
  
  METHODS
  We conducted a retrospective audit of respiratory arrests within our hospital over a 6-year period. Data were collected regarding patient characteristics, preceding clinical state, presumed causes and outcomes of arrests. We also compared outcomes of respiratory arrests to that of cardiac arrests occurring over the same period.
  
  
  RESULTS
  We identified 82 respiratory arrests, occurring at a rate of 0.57/1000 inpatient admissions. Pre-existing respiratory, neurologic and cardiac disease was common, as was multi-morbidity. Preceding clinical instability was evident in 39% of arrests, most commonly elevated respiratory rate or progressive hypoxia. Pulmonary oedema was the most common cause of respiratory arrest followed by aspiration, neurologic events, medication side-effects, and tracheostomy-tube complications. In-hospital mortality for respiratory arrests was 25.1%, compared with 74.9% for cardiac arrests (p<0.001) over the same time period.
  
  
  CONCLUSIONS
  Although rare, respiratory arrests are associated with significantly lower in-hospital mortality than cardiac arrests. Further studies are needed to better predict respiratory arrests and identify interventions to reduce incidence and improve outcomes.
authors.affiliation: Institute of Breathing and Sleep, Austin Hospital, Melbourne, Australia. Electronic address: angushusband@gmail.com.
authors.forename: Angus
authors.initials: A
authors.lastname: Husband
authors.affiliation: Department of Intensive Care, Austin Hospital, Melbourne, Australia.
authors.forename: Inga
authors.initials: I
authors.lastname: Mercer
authors.affiliation: Institute of Breathing and Sleep, Austin Hospital, Melbourne, Australia.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Detering
authors.affiliation: Department of Intensive Care, Austin Hospital, Melbourne, Australia.
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Eastwood
authors.affiliation: Department of Intensive Care, Austin Hospital, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Daryl A
authors.initials: DA
authors.lastname: Jones
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000453:epidemiology*; D012189:Retrospective Studies
keywords: Epidemiology; Outcome; Respiratory arrest; Respiratory failure; Resuscitation