title: Temporal patterns of change in vital signs and Cardiac Arrest Risk Triage scores over the 48 hours preceding fatal in-hospital cardiac arrest.
abstract: OBJECTIVE
  To determine temporal patterns of vital sign and Cardiac Arrest Risk Triage score changes over the 48-hour period preceding cardiac arrest in an ICU setting.
  
  
  BACKGROUND
  Vital sign instability usually occurs prior to cardiac arrest. However, few studies have been conducted on the temporal patterns of individual vital signs preceding cardiac arrest.
  
  
  METHODS
  A retrospective case-control study.
  
  
  METHODS
  The study subjects were 140 ICU patients (1 June 2011-31 December 2012): 46 died of cardiac arrest (case group), 45 died of other illnesses (control I group) and 49 were discharged after recovering (control II group).
  
  
  RESULTS
  Initial detectable changes in blood pressure appeared 18-20 hours and became dramatic at 5-10 hours before cardiac arrest. Noticeable changes in heart rates began at 4 hours and became more prominent at 2 hours pre-arrest. No apparent patterns in respiratory rate changes were observed. Body temperatures usually indicated a hypothermic state pre-arrest. Cardiac Arrest Risk Triage scores were 16-18 at 48 hours pre-arrest and then continuously increased to 20. Only mean values of systolic blood pressures were significantly different between the three study groups. Mean diastolic blood pressures, heart rates, respiratory rates and Cardiac Arrest Risk Triage scores differed between the case and control II groups and between the control I and II groups.
  
  
  CONCLUSIONS
  The study demonstrates vital sign instability preceded cardiac arrest and that the temporal patterns of changes in individual vital signs and Cardiac Arrest Risk Triage scores differed between groups. The findings of this study may aid the development of management strategies for cardiac arrest.
authors.affiliation: Department of Nursing, Inha University, Incheon, Korea.
authors.forename: HyunSoo
authors.initials: H
authors.lastname: Oh
authors.affiliation: Department of Nursing, Inha University, Incheon, Korea.|Surgical Intensive Care Unit, Inha University Hospital, Incheon, Korea.
authors.forename: KangIm
authors.initials: K
authors.lastname: Lee
authors.affiliation: Department of Nursing, Inha University, Incheon, Korea.
authors.forename: WhaSook
authors.initials: W
authors.lastname: Seo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D064648:Critical Care Nursing / Q000379:methods; D036262:Empirical Research; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000503:physiopathology; D017052:Hospital Mortality; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D013997:Time Factors; D014218:Triage; D055986:Vital Signs / Q000502:physiology*
keywords: cardiac arrest; case-control study; critical care nursing; vital signs