title: Characterization of cardiac arrest in the emergency department of a Brazilian University Reference Hospital: A prospective study.
abstract: OBJECTIVE
  Sudden cardiac arrest (CA) represents one of the greatest challenges for medicine due to the vast number of cases and its social and economic impact. Despite advances in cardiopulmonary resuscitation (CPR) techniques, mortality rates have not significantly decreased over decades. This study was undertaken to characterize patients that have suffered CA and to identify factors related to mortality.
  
  
  METHODS
  This prospective study was conducted at Emergency Department of São Paulo Hospital, Brazil. Two hundred and eighty five patients were followed for one year after treatment for CA. The mean age was 66.3±17.2 yr, and they were predominantly male (55.8%) and Caucasian (71.9%). Mortality rate and factors associated with mortality were the primary and secondary outcome measures. Data were collected using an in-hospital Utstein-style report. A logistic regression analysis was used to determine which variables were related to mortality.
  
  
  RESULTS
  Regarding the characteristics of CPR, 76.5 per cent occurred in hospital, respiratory failure was the most common presumed immediate cause of CA (30.8%) and pulseless electrical activity was the most frequent initial rhythm (58.7%). All attempts at CPR utilized chest compressions and ventilation and the most utilized interventions were epinephrine (97.2%) and intubation (68.5%). Of all patients treated, 95.4 per cent died. Patients with pulseless electrical activity had a higher risk of death than those patients with ventricular fibrillation.
  
  
  CONCLUSIONS
  The findings of the study highlighted that the mortality rate among CA patients was high. The variable that best explained mortality was the initial CA rhythm.
authors.affiliation: Paulista School of Nursing/Federal University of Sao Paulo, 754 Napoleao de Barros Street, São Paulo, SP 04024-002, Brazil.
authors.forename: Cassia Regina
authors.initials: CR
authors.lastname: Vancini-Campanharo
authors.affiliation: Federal University of Espirito Santo, 173 Feliciano Bicudo Street, Sao Paulo, SP 02301-020, Brazil.
authors.forename: Rodrigo Luiz
authors.initials: RL
authors.lastname: Vancini
authors.affiliation: Federal University of Goias, Goiania, GO 74001-970, Brazil.
authors.forename: Claudio Andre Barbosa
authors.initials: CA
authors.lastname: de Lira
authors.affiliation: Federal University of Sao Paulo, 862 Botucatu Street, Sao Paulo, SP 04023-062, Brazil.
authors.forename: Marília Dos Santos
authors.initials: MD
authors.lastname: Andrade
authors.affiliation: Paulista School of Nursing/Federal University of Sao Paulo, 754 Napoleao de Barros Street, São Paulo, SP 04024-002, Brazil.
authors.forename: Maria Carolina Barbosa Teixeira
authors.initials: MC
authors.lastname: Lopes
authors.affiliation: Paulista School of Nursing/Federal University of Sao Paulo, 754 Napoleao de Barros Street, São Paulo, SP 04024-002, Brazil.
authors.forename: Meiry Fernanda Pinto
authors.initials: MF
authors.lastname: Okuno
authors.affiliation: Paulista School of Nursing/Federal University of Sao Paulo, 754 Napoleao de Barros Street, São Paulo, SP 04024-002, Brazil.
authors.forename: Ruth Ester Assayag
authors.initials: RE
authors.lastname: Batista
authors.affiliation: Paulista School of Medicine/ Federal University of Sao Paulo, 740 Botucatu Street, Sao Paulo, SP 04023-062, Brazil.
authors.forename: Álvaro Nagib
authors.initials: ÁN
authors.lastname: Atallah
authors.affiliation: Paulista School of Medicine/ Federal University of Sao Paulo, 740 Botucatu Street, Sao Paulo, SP 04023-062, Brazil.
authors.forename: Aécio Flávio Teixeira
authors.initials: AF
authors.lastname: de Góis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D016887:Cardiopulmonary Resuscitation; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000473:pathology; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged