scholarly journals In-hospital cardiac arrest incidence and outcomes in the era of COVID-19: an observational study in a Singapore hospital

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Ting Lyu ◽  
Faheem Ahmed Khan ◽  
Shanaz Matthew Sajeed ◽  
Amit Kansal ◽  
Monika Gulati Kansal ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Discharge ◽  
Primary Outcome ◽  
Hospital Admissions ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Code Blue ◽  
Secondary Outcomes ◽  
Hospital Cardiac Arrest

Abstract Background COVID-19 pandemic has resulted in significant strain on healthcare resources and this requires diligent resource re-allocation. We aim to describe the incidence and outcomes of in-hospital cardiac arrest (IHCA) during this period as compared to non-pandemic period. Methods We conducted a retrospective study in a tertiary care hospital in Singapore. The study compared the incidence and outcomes of code blue activations over a 3-month period from March to May 2020 (COVID-19 period) with the same months in 2019 (pre-COVID-19 period). The primary outcome of the study was the rate of survival to hospital discharge for IHCA. The secondary outcomes included incidence of all code blue activation per 1000 hospital admissions, incidence of IHCA per 1000 hospital admissions. Outcomes The rate of survival to hospital discharge for IHCA was 5.88% in the COVID-19 period as compared to 10.0% in the pre-COVID-19 period [odds ratio (OR), 0.72; 95% confidence interval (CI), 0.26-1.95]. Compared to pre-COVID-19 period, there were more IHCA incidences per 1000 hospital admissions in the COVID-19 period (1.86 vs 1.03; OR, 1.81; 95% CI, 0.78-4.41). Conclusions The study observed a trend towards higher incidence of IHCA and lower rate of survival to hospital discharge during COVID-19 pandemic compared to pre-COVID-19 period.

scholarly journals Long-term outcomes and predictors of survival after cardiopulmonary resuscitation for in-hospital cardiac arrest in a tertiary care hospital in Thailand

2018 ◽  
Vol Volume 14 ◽  
pp. 583-589 ◽  
Author(s):  
Panita Limpawattana ◽  
Wannaporn Aungsakul ◽  
Chomchanok Suraditnan ◽  
Anupol Panitchote ◽  
Boonsong Patjanasoontorn ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Long Term Outcomes ◽  
Hospital Cardiac Arrest

Epidemiology of in-hospital cardiac arrest in a Pakistani tertiary care hospital pre- and during COVID-19 pandemic

2021 ◽  
Vol 38 (ICON-2022) ◽  
Author(s):  
Faiza Ahmed ◽  
Lubna Abbasi ◽  
Nida Ghouri ◽  
Muhammad Junaid Patel
Keyword(s):  
Gender Differences ◽  
Cardiac Arrest ◽  
Tertiary Care Hospital ◽  
Small Sample Size ◽  
Tertiary Care ◽  
Small Sample ◽  
Care Hospital ◽  
Cross Sectional ◽  
Shockable Rhythm ◽  
Hospital Cardiac Arrest

Objectives: To determine epidemiology of in-hospital cardiac arrest (IHCA) in a tertiary care hospital, pre- and during pandemic. Methods: This is a cross-sectional study of inpatients who experienced an in-hospital-cardiac arrest at a tertiary care hospital in Karachi between August 2019 and August 2020. Outcome variables were return of spontaneous circulation (ROSC) and survival to discharge (StD) and analysis was also done comparing pre- and during pandemic period. Results: A total of 77 patients experienced at least one IHCA event during the 1-year study period. Comparing pre- and during pandemic, ROSC for women was higher during the pandemic albeit not significant (43% vs 50%) in comparison to men (54% vs 10%, p<0.001). During the pandemic, women with IHCA were significantly younger than men (μ ± sd; 36.8 ± 15.3 vs 55.9 ± 12.7, p=0.001,) whereas pre-pandemic, there was no gender differences in mean age. Non-shockable rhythm was more common (92.2%) than shockable rhythm (6.5%). Pre- and during pandemic, there were significant differences in the cause of IHCA for 4H4T (87% vs 100%) and cardiac (36% vs 9%). The proportion of hypoxic patients increased from 50% during pre-pandemic to 91% during the pandemic period, whereas hypo/hyperkalemia decreased from 53% to 34%. Conclusion: Despite the limitation of a small sample size, our study has provided important information regarding the epidemiology and outcomes of IHCA pre- and during pandemic in a busy Pakistani tertiary care hospital. Our finding that gender differences exist in survival pre- and during pandemic needs to be explored further with more hospitals doing comparative studies. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5776 How to cite this:Ahmed F, Abbasi L, Ghouri N, Patel MJ. Epidemiology of in-hospital cardiac arrest in a Pakistani tertiary care hospital pre- and during COVID-19 pandemic. Pak J Med Sci. 2022;38(2):387-392. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5776 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals The prevalence of bacteremia in out of hospital cardiac arrest patients presenting to the emergency department of a tertiary care hospital

2021 ◽  
Vol 53 (1) ◽  
pp. 1207-1215
Author(s):  
Gilbert Abou Dagher ◽  
Ralph Bou Chebl ◽  
Rawan Safa ◽  
Mohammad Assaf ◽  
Nadim Kattouf ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Hospital Cardiac Arrest

PROSPECTIVE ANALYSIS OF THE CODE BLUE SYSTEM IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 26-30
Author(s):  
Laishram Linthoingambi ◽  
Rahul Agarwal
Keyword(s):  
Overall Survival ◽  
Cardiac Arrest ◽  
Survival Rate ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Technical Equipment ◽  
Care Hospital ◽  
Cox Regression Analysis ◽  
Code Blue ◽  
Audit Form

BACKGROUND: This study was an analysis done to ascertain the efciency of the code blue system in a tertiary care hospital. All patients on whom a 'Code Blue' has been called in Command Hospital (Eastern Command) Kolkata from January 2017 to July 2018 were analysed using the standardised Code Blue audit form, maintained by the Department of Anaesthesiology & Critical Care and lled in soon after the Code Blue protocol is run. The primary objective was to analyse the factors associated with survival as well as survival rate along with the issues faced by the Code Blue team.METHODS: Data was collected as per the Code Blue audit form and analysed RESULTS: SPSS software version 22 was used. Pearson Chi Square Test and Cox Regression analysis were used to analyse the data. Atotal of 446 code blue calls were initiated during the period. After excluding 40 False calls and 08 Administrative calls, 398 calls were studied and analysed. Overall survival discharge from ICU was 23.37%. But when patients who had a cardiac arrest at the time of code blue were considered, the survival rate dropped to 5.9%. Factors such as Age, Presenting Rhythm and Duration of CPR were found to have signicant effect on overall survival. Four types of problems were faced during the study – technical, equipment related, crash cart related and staff on duty.CONCLUSION: The study concludes that the code blue system and team is useful in managing patients with a cardiac arrest as well as other medical emergencies. However, there are many lacunae that need to be addressed and more studies are required.

scholarly journals Epidemiology of in-hospital cardiac arrest in Abu Dhabi, United Arab Emirates, 2013–2015

Heart Asia ◽  
2018 ◽  
Vol 10 (2) ◽  
pp. e011029 ◽  
Author(s):  
Faisal Aziz ◽  
Marilia Silva Paulo ◽  
Emad H Dababneh ◽  
Tom Loney
Keyword(s):  
Cardiac Arrest ◽  
United Arab Emirates ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Time Of Day ◽  
Abu Dhabi ◽  
Survival Outcomes ◽  
Care Hospital ◽  
Shockable Rhythm ◽  
Hospital Cardiac Arrest

ObjectiveEstimate the incidence and outcomes of in-hospital cardiac arrest (IHCA) in a tertiary-care hospital in Abu Dhabi emirate, United Arab Emirates (UAE).MethodsRetrospective data from 685 inpatients who experienced an IHCA at a hospital in Abu Dhabi (UAE) between 1 January 2013 and 31 December 2015 were analysed. Sociodemographic variables were age and gender, and IHCA event variables were shift, day, event location, initial cardiac rhythm and the total number of IHCA events. Outcome variables were the return of spontaneous circulation (ROSC) and survival to discharge (StD).ResultsThe incidence of IHCA was 11.7 (95% CI 10.8 to 12.6) per 1000 hospital admissions. Non-shockable rhythms were 91.1% of the cardiac rhythms at presentation. The majority of IHCA cases occurred in the intensive care unit (46.1%) and on weekdays (74.6%). More than a third (38.3%) of patients who experienced an IHCA achieved ROSC and 7.7% StD. Both ROSC and StD were significantly higher in patients who were younger and presenting with a shockable rhythm (all p’s≤0.05). Survival outcomes were not significantly different between dayshifts and nightshifts or weekdays and weekends.ConclusionsThe incidence of IHCA was higher and its outcomes were lower compared with other high-income/developed countries. Survival outcomes were better for patients who were younger and had a shockable rhythm, and similar between time of day and days of the week. These findings may help to inform health managers about the magnitude and quality of IHCA care in the UAE.

scholarly journals Intraosseous versus intravenous vascular access during cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a systematic review and meta-analysis of observational studies

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Yu-Lin Hsieh ◽  
Meng-Che Wu ◽  
Jon Wolfshohl ◽  
James d’Etienne ◽  
Chien-Hua Huang ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Hospital Discharge ◽  
Vascular Access ◽  
Subgroup Analysis ◽  
Observational Studies ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Hospital Cardiac Arrest

Abstract Introduction This study is aimed to investigate the association of intraosseous (IO) versus intravenous (IV) route during cardiopulmonary resuscitation (CPR) with outcomes after out-of-hospital cardiac arrest (OHCA). Methods We systematically searched PubMed, Embase, Cochrane Library and Web of Science from the database inception through April 2020. Our search strings included designed keywords for two concepts, i.e. vascular access and cardiac arrest. There were no limitations implemented in the search strategy. We selected studies comparing IO versus IV access in neurological or survival outcomes after OHCA. Favourable neurological outcome at hospital discharge was pre-specified as the primary outcome. We pooled the effect estimates in random-effects models and quantified the heterogeneity by the I2 statistics. Time to intervention, defined as time interval from call for emergency medical services to establishing vascular access or administering medications, was hypothesized to be a potential outcome moderator and examined in subgroup analysis with meta-regression. Results Nine retrospective observational studies involving 111,746 adult OHCA patients were included. Most studies were rated as high quality according to Newcastle-Ottawa Scale. The pooled results demonstrated no significant association between types of vascular access and the primary outcome (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.27–1.33; I2, 95%). In subgroup analysis, time to intervention was noted to be positively associated with the pooled OR of achieving the primary outcome (OR: 3.95, 95% CI, 1.42–11.02, p: 0.02). That is, when the studies not accounting for the variable of “time to intervention” in the statistical analysis were pooled together, the meta-analytic results between IO access and favourable outcomes would be biased toward inverse association. No obvious publication bias was detected by the funnel plot. Conclusions The meta-analysis revealed no significant association between types of vascular access and neurological outcomes at hospital discharge among OHCA patients. Time to intervention was identified to be an important outcome moderator in this meta-analysis of observation studies. These results call for the need for future clinical trials to investigate the unbiased effect of IO use on OHCA CPR.

PaRamEDIc assessment of laCTate in OHCA and survival to hospital (PREDICT protocol)

2021 ◽  
Vol 13 (3) ◽  
pp. 100-104
Author(s):  
Karl Charlton ◽  
Hayley Moore
Keyword(s):  
Cardiac Arrest ◽  
Primary Outcome ◽  
Spontaneous Circulation ◽  
Prognostic Role ◽  
Single Centre ◽  
Intravenous Access ◽  
Secondary Outcomes ◽  
Cardiac Arrest Survival ◽  
Hospital Cardiac Arrest

Background: Studies suggest that blood lactate differs between survivors and non-survivors of out-of-hospital cardiac arrest who are transported to hospital. The prognostic role of lactate taken during out-of-hospital cardiac arrest remains unexplored. Aims: To measure the association between lactate taken during out-of-hospital cardiac arrest, survival to hospital and 30-day mortality. Methods: This is a feasibility, single-centre, prospective cohort study. Eligible for inclusion are patients aged ≥18 years suffering out-of-hospital cardiac arrest, receiving cardiopulmonary resuscitation, in the catchment of Newcastle or Gateshead hospitals, who are attended to by a study-trained specialist paramedic. Exclusions are known/apparent pregnancy, blunt or penetrating injury as primary cause of out-of-hospital cardiac arrest and an absence of intravenous access. Between February 2020 and March 2021, 100 participants will be enrolled. Primary outcome is survival to hospital; secondary outcomes are return of spontaneous circulation at any time and 30-day mortality.

Patient-related factors associated with severe heat-related illnesses in Karachi: A hospital perspective

2020 ◽  
pp. 1-8
Author(s):  
Saima Kanwal ◽  
Sara Sajid ◽  
Noreen Nasir ◽  
Syed Ahsan ◽  
Aysha Almas
Keyword(s):  
Hospital Mortality ◽  
Hospital Admissions ◽  
Tertiary Care Hospital ◽  
Heat Stroke ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Related Factors ◽  
Hospital Perspective ◽  
The Mean

Abstract In 2015, Karachi saw its first ever epidemic of severe heat-related illnesses that resulted in an extraordinary number of hospital admissions, especially in the intensive care, for fatal heat stroke within-hospital mortality of 3.7%.We conducted this study to elucidate the patient-related factors that lead to an increase in hospital admissions with heat-related illnesses in a tertiary care hospital. It was a descriptive case series conducted in the department of medicine at the Aga Khan University in June 2015. A total of 134 patients were admitted with heat-related illnesses of which 76(56.7%) were males. The mean age of the patients was 66 ±14.5 years. Heatstroke was present in 86 (64.2%) patients, followed by heat exhaustion in 48 (35.8%) and in-hospital mortality from heat-related illnesses was 5(3.7%). Continuous...  

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