[Outcome among patients suffering from in-hospital cardiac arrest].
BACKGROUND
In relation to pre-hospital treatment of patients with cardiac arrest (CA) in the field where resuscitation is often started by nonprofessionals, resuscitation in hospital is most commonly performed by well-trained personnel.


OBJECTIVE
The aim was to define the factors associated with an improved outcome among patients suffering from the in-hospital CA (IHCA).


METHODS
The prospective study included a total of 100 patients in the Emergency Center over two-year period.The patterns by the Utstein-Style guidelines recorded the following: age, sex, reason for hospital admission, comorbidity, cause and origin of CA, continuous monitoring, time of arrival of the medical emergency team and time of delivery of the first defibrillation shock (DC).


RESULTS
Most patients (61%) had cardiac etiology. Return of spontaneous circulation (ROSC) was achieved in 58% of patients. ROSC was more frequently achieved in younger patients (57.69 +/- 11.37), (p < 0.05), non-surgical patients (76.1%), (p < 0.01) and in patients who were in continuous monitoring (66.7%) (p < 0.05). The outcome of CPR was significantly better in patients who received advanced life support (ALS) (76.6%) (p < 0.01). Time until the delivery of the first DC shock was significantly shorter in patients who achieved ROSC (1.67 +/- 1.13 min), (p < 0.01). A total of 5% of IHCA patients survived to hospital discharge.


CONCLUSIONS
In our study, the outcome of CPR was better in patients who were younger and with non-surgical diseases, which are prognostic factors that we cannot control. Factors associated with better outcome of IHCA patients were: continuous monitoring, shorter time until the delivery of the first DC and ALS. This means that better education of medical staff, better organization and up-to-dated technical equipment are needed.
Sladjana
S
Trpković
Aleksandar
A
Pavlović
Vesna
V
Bumbasirević
Ana
A
Sekulić
Biljana
B
Milicić
D000328:Adult; D022561:Advanced Cardiac Life Support / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D055815:Young Adult