Quality of Cardiopulmonary Resuscitation and 5-Year Survival Following in-Hospital Cardiac Arrest

Figures & data

Figure 1 Flow chart of all cardiac arrest calls. *Not cardiac arrest includes loss of consciousness, seizures, and respiratory failure without cardiac arrest, as evaluated by the treating physicians.

Abbreviations: IHCA, in-hospital cardiac arrest; OHCA, out-of hospital cardiac arrest.

Table 1 Cardiac Arrest Variables

Number of IHCA	189
Male (N(%))	123 (65)
Witnessed cardiac arrest (N(%))
- Yes	143 (76)
- No	37 (20)
- Not documented in patient record	9 (5)
IHCA time of day (N(%))
Day 08.00 AM–03.59 PM	88 (47)
Evening 04.00 PM–11.59 PM	49 (26)
Night 12.00 AM–07.59 AM	52 (28)
Cardiac arrest location (N(%))
Internal Medicine Ward	46 (24)
Cardiology Ward	42 (22)
Intensive Care Unit	30 (16)
Surgical Wards	28 (15)
Emergency Care Unit	13 (7)
Neurology Ward	10 (5)
Oncology Ward	7 (4)
Other*	13 (7)

Notes: *Other=Psychiatric ward, elevators, main entrance hall, radiation therapy, operating rooms, recovery unit, radiology department.

Abbreviation: IHCA, in-hospital cardiac arrest.

Table 2 Cardiopulmonary Resuscitation Quality Metrics

Median cardiac arrest episode duration per patient	391 (176–804) sec
Median time to first defibrillation	133 (82–264) sec
Time to first rhythm analysis	116 (70–201) sec
Median chest compressions rate	126 (119–131) min^−1
Median chest compression fraction	78 (69–86) %

Note: All results are presented as median (quartile 1 – quartile 3).

Table 3 Chest Compression Rate and Fraction

	ROSC	30-Day Survival	1-Year Survival	3-Year Survival	5-Year Survival
Chest Compression rate 100–120 per minute
- Unadjusted OR [95% CI]	0.55 [0.25–1.19]	1.01 [0.42–2.43]	1.05 [0.42–2.64]	1.14 [0.40–3.26]	0.93 [0.29–2.90]
- Adjusted* OR [95% CI]	0.60 [0.31–1.17]	2.04 [1.30–3.18]	1.67 [0.80–3.47]	2.50 [1.23–5.08]	1.65 [0.73–3.70]
Chest Compression Fraction CCF >80%
- Unadjusted OR [95% CI]	0.77 [0.37–1.60]	0.18 [0.06–0.57]	0.21 [0.07–0.66]	0.32 [0.08–1.25]	0.42 [0.11–1.67]
- Adjusted* OR [95% CI]	0.46 [0.07–2.98]	0.22 [0.04–1.11]	0.40 [0.05–2.96]	0.82 [0.21–3.15]	0.79 [0.21–2.95]

Notes: Odds ratio unadjusted and adjusted (*) for age, first rhythm, intubation, use of automated external defibrillator, Charlson comorbidity Index, witnessed cardiac arrest, and episode duration.

Table 4 Cardiac Arrest Survival

	ROSC	30-Day Survival	1-Year Survival	3-Year Survival	5-Year Survival
Survival (N (%))	100 (53)	47 (25)	40 (21)	27 (14)	25 (13)

Abbreviation: ROSC, return of spontaneous circulation.

Table 5 Comparison of Patients with 5-Year Survival vs No 5-Year Survival

	5-Year Survival	No 5-Year Survival	p-value
Total, N (%)	25 (13)	164 (87)
Age in years (median (Q1–Q3))	68 (59–73)	74 (66–84)	0.003
Male (N (%))	17 (68)	106 (65)	0.74
Cardiac arrests in telemetry equipped wards (N (%))	11 (44)	61 (37)
Charlson comorbidity index (median (Q1–Q3))	3 (2–4)	5 (3–6)	<0.001
Witnessed cardiac arrest of patients with recorded data (N (%))	23 (96)*	120 (77)*	0.03
First rhythm: Shockable (N (%))	8 (44)*	17 (15)*
Time to first shock in sec (median (Q1–Q3))	133 (73–171)	138 (83–293)	0.71
Time to first rhythm analysis in sec (median (Q1–Q3))	238 (104–382)	110 (69–185)	0.05
Episode duration sec (median (Q1–Q3))	144 (72–270)	415 (206–855)	0.002
Chest compression fraction (% (Q1–Q3))	73 (68–80)	78 (69–86)	0.52
Compression rate per minute during compressions (median (Q1–Q3))	125 (119–134)	126 (119–131)	0.88

Notes: Q1=25% percentile. Q3=75% percentile. *Fraction is shown as percent of patients with available data on this parameter.