title: A 20-year perspective of in hospital cardiac arrest: Experiences from a university hospital with focus on wards with and without monitoring facilities.
abstract: BACKGROUND
  Knowledge about change in the characteristics and outcome of in hospital cardiac arrests (IHCAs) is insufficient.
  
  
  OBJECTIVE
  To describe a 20year perspective of in hospital cardiac arrest (IHCA) in wards with and without monitoring capabilities.
  
  
  METHODS
  Sahlgrenska University Hospital (800 beds). The number of beds varied during the time of survey from 850-746 TIME: 1994-2013.
  
  
  METHODS
  Retrospective registry study. Patients were assessed in four fiveyear intervals.
  
  
  METHODS
  Witnessed and nonwitnessed IHCAs when cardiopulmonary resuscitation (CPR) was attempted.
  
  
  METHODS
  Age below 18years.
  
  
  RESULTS
  In all, there were 2340 patients with IHCA during the time of the survey. 30-Day survival increased significantly in wards with monitoring facilities from 43.5% to 55.6% (p=0.002) for trend but not in wards without such facilities (p=0.003 for interaction between wards with/without monitoring facilities and time period). The CPC-score among survivors did not change significantly in any of the two types of wards. In wards with monitoring facilities there was a significant reduction of the delay time from collapse to start of CPR and an increase in the proportion of patients who were defibrillated before the arrival of the rescue team. In wards without such facilities there was a significant reduction of the delay from collapse to defibrillation. However, the latter observation corresponds to a marked decrease in the proportion of patients found in ventricular fibrillation.
  
  
  CONCLUSIONS
  In a 20year perspective the treatment of in hospital cardiac arrest was characterised by a more rapid start of treatment. This was reflected in a significant increase in 30-day survival in wards with monitoring facilities. In wards without such facilities there was a decrease in patients found in ventricular fibrillation.
authors.affiliation: Sahlgrenska University Hospital, Bla Straket 5, plan 5,41345 Gothenburg, Sweden. Electronic address: anna_adielsson@hotmail.com.
authors.forename: Anna
authors.initials: A
authors.lastname: Adielsson
authors.affiliation: University of Gothenburg, Box 414, 40530 Gothenburg, Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Karlsson
authors.affiliation: Per Dubbsgatan 14413 45, Gothenburg, Sweden.
authors.forename: Solveig
authors.initials: S
authors.lastname: Aune
authors.affiliation: Sahlgrenska University Hospital, Bla Straket 5, plan 5,41345 Gothenburg, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Lundin
authors.affiliation: Sahlgrenska University Hospital, Bla Straket 3, 41345 Gothenburg, Sweden.
authors.forename: Geir
authors.initials: G
authors.lastname: Hirlekar
authors.affiliation: Hogskolan i Boras Kunskapscentrum PreHospen, 501 90 Boras, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Herlitz
authors.affiliation: Sahlgrenska University Hospital, Bla Straket 3, 41345 Gothenburg, Sweden.
authors.forename: Annica
authors.initials: A
authors.lastname: Ravn-Fischer
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000401:mortality*; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: CPC-score; CPR; Defibrillation; Delay; In-hospital cardiac arrest; Survival