title: Causes of in-hospital cardiac arrest - incidences and rate of recognition.
abstract: METHODS
  Do emergency teams (ETs) consider the underlying causes of in-hospital cardiac arrest (IHCA) during advanced life support (ALS)? In a 4.5-year prospective observational study, an aetiology study group examined 302 episodes of IHCA. The purpose was to investigate the causes and cause-related survival and to evaluate whether these causes were recognised by the ETs.
  
  
  RESULTS
  In 258 (85%) episodes, the cause of IHCA was reliably determined. The cause was correctly recognised by the ET in 198 of 302 episodes (66%). In the majority of episodes, cardiac causes (156, 60%) or hypoxic causes (51, 20%) were present. The cause-related survival was 30% for cardiac aetiology and 37% for hypoxic aetiology. The initial cardiac rhythm was pulseless electrical activity (PEA) in 144 episodes (48%) followed by asystole in 70 episodes (23%) and combined ventricular fibrillation/ventricular tachycardia (VF/VT) in 83 episodes (27%). Seventy-one patients (25%) survived to hospital discharge. The median delay to cardiopulmonary resuscitation (CPR) was 1min (inter-quartile range 0-1min).
  
  
  CONCLUSIONS
  Various cardiac and hypoxic aetiologies dominated. In two-thirds of IHCA episodes, the underlying cause was correctly identified by the ET, i.e. according to the findings of the aetiology study group.
authors.affiliation: Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Department of Anaesthesia and Intensive Care Medicine, St. Olav University Hospital, Trondheim, Norway; Norwegian Air Ambulance Foundation, Norway. Electronic address: daniel.bergum@ntnu.no.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bergum
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, St. Olav University Hospital, Trondheim, Norway; Norwegian Air Ambulance Foundation, Norway.
authors.forename: Trond
authors.initials: T
authors.lastname: Nordseth
authors.affiliation: Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Department of Cardiology, St. Olav University Hospital, Trondheim, Norway.
authors.forename: Ole Christian
authors.initials: OC
authors.lastname: Mjølstad
authors.affiliation: Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Department of Anaesthesia and Intensive Care Medicine, St. Olav University Hospital, Trondheim, Norway.
authors.forename: Eirik
authors.initials: E
authors.lastname: Skogvoll
authors.affiliation: Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Department of Cardiology, St. Olav University Hospital, Trondheim, Norway.
authors.forename: Bjørn Olav
authors.initials: BO
authors.lastname: Haugen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D006801:Humans; D000860:Hypoxia / Q000150:complications*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010351:Patient Discharge; D011446:Prospective Studies; D017180:Tachycardia, Ventricular / Q000150:complications*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D061665:Time-to-Treatment; D016896:Treatment Outcome
keywords: Advanced life support; Cardiac arrest; Cardiopulmonary resuscitation; Causes of cardiac arrest; Chain of survival; In-hospital cardiac arrest