scholarly journals In-hospital Cardiac Arrest in Patients With Sepsis: A National Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Catherine Duazo ◽  
Jo-Ching Hsiung ◽  
Frank Qian ◽  
Charles Fox Sherrod ◽  
Dean-An Ling ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Arrest ◽  
Cohort Study ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Organ Dysfunction ◽  
Risk Index ◽  
Cardiac Risk ◽  
Tract Infections ◽  
Hospital Cardiac Arrest

Background: Little is known about the risk of in-hospital cardiac arrest (IHCA) among patients with sepsis. We aimed to characterize the incidence and outcome of IHCA among patients with sepsis in a national database. We then determined the major risk factors associated with IHCA among sepsis patients.Methods: We used data from a population-based cohort study based on the National Health Insurance Research Database of Taiwan (NHRID) between 2000 and 2013. We used Martin's implementation that combined the explicit ICD-9 CM codes for sepsis and six major organ dysfunction categories. IHCA among sepsis patients was identified by the presence of cardiopulmonary resuscitation procedures. The survival impact was analyzed with the Cox proportional-hazards model using inverse probability of treatment weighting (IPTW). The risk factors were identified by logistic regression models with 10-fold cross-validation, adjusting for competing risks.Results: We identified a total of 20,022 patients with sepsis, among whom 2,168 developed in-hospital cardiac arrest. Sepsis patients with a higher burden of comorbidities and organ dysfunction were more likely to develop in-hospital cardiac arrest. Acute respiratory failure, hematological dysfunction, renal dysfunction, and hepatic dysfunction were associated with increased risk of IHCA. Regarding the source of infection, patients with respiratory tract infections were at the highest risk, whereas patients with urinary tract infections and primary bacteremia were less likely to develop IHCA. The risk of IHCA correlated well with age and revised cardiac risk index (RCRI). The final competing risk model concluded that acute respiratory failure, male gender, and diabetes are the three strongest predictors for IHCA. The effect of IHCA on survival can last 1 year after hospital discharge, with an IPTW-weighted hazard ratio of 5.19 (95% CI: 5.06, 5.35) compared to patients who did not develop IHCA.Conclusion: IHCA in sepsis patients had a negative effect on both short- and long-term survival. The risk of IHCA among hospitalized sepsis patients was strongly correlated with age and cardiac risk index. The three identified risk factors can help clinicians to identify patients at higher risk for IHCA.

scholarly journals Risk factors and outcomes for acute respiratory failure in coronavirus disease 2019: An observational cohort study

2020 ◽  
Vol 30 (2) ◽  
pp. 0-0
Author(s):  
Paweł Piwowarczyk ◽  
Marta Szczukocka ◽  
Paweł Kutnik ◽  
Michał Borys ◽  
Anna Mikłaszewska ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Observational Cohort Study ◽  
Observational Cohort

scholarly journals Acute respiratory failure and inflammatory response after out-of-hospital cardiac arrest: results of the Post-Cardiac Arrest Syndrome (PCAS) pilot study

2020 ◽  
Vol 9 (4_suppl) ◽  
pp. S110-S121
Author(s):  
Katarzyna Czerwińska-Jelonkiewicz ◽  
Johannes Grand ◽  
Guido Tavazzi ◽  
Jordi Sans-Rosello ◽  
Alice Wood ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Respiratory Failure ◽  
Inflammatory Response ◽  
Acute Respiratory Failure ◽  
White Blood Cells ◽  
Short Term ◽  
Reactive Protein ◽  
Short Term Mortality ◽  
Post Cardiac Arrest Syndrome ◽  
Hospital Cardiac Arrest

Background: Although the lungs are potentially highly susceptible to post-cardiac arrest syndrome injury, the issue of acute respiratory failure after out-of-hospital cardiac arrest has not been investigated. The objectives of this analysis were to determine the prevalence of acute respiratory failure after out-of-hospital cardiac arrest, its association with post-cardiac arrest syndrome inflammatory response and to clarify its importance for early mortality. Methods: The Post-Cardiac Arrest Syndrome (PCAS) pilot study was a prospective, observational, six-centre project (Poland 2, Denmark 1, Spain 1, Italy 1, UK 1), studying patients resuscitated after out-of-hospital cardiac arrest of cardiac origin. Primary outcomes were: (a) the profile of organ failure within the first 72 hours after out-of-hospital cardiac arrest; (b) in-hospital and short-term mortality, up to 30 days of follow-up. Respiratory failure was defined using a modified version of the Berlin acute respiratory distress syndrome definition. Inflammatory response was defined using leukocytes (white blood cells), platelet count and C-reactive protein concentration. All parameters were assessed every 24 hours, from admission until 72 hours of stay. Results: Overall, 148 patients (age 62.9±15.27 years; 27.7% women) were included. Acute respiratory failure was noted in between 50 (33.8%) and 75 (50.7%) patients over the first 72 hours. In-hospital and short-term mortality was 68 (46.9%) and 72 (48.6%), respectively. Inflammation was significantly associated with the risk of acute respiratory failure, with the highest cumulative odds ratio of 748 at 72 hours (C-reactive protein 1.035 (1.001–1.070); 0.043, white blood cells 1.086 (1.039–1.136); 0.001, platelets 1.004 (1.001–1.007); <0.005). Early acute respiratory failure was related to in-hospital mortality (3.172, 95% confidence interval 1.496–6.725; 0.002) and to short-term mortality (3.335 (1.815–6.129); 0.0001). Conclusions: An inflammatory response is significantly associated with acute respiratory failure early after out-of-hospital cardiac arrest. Acute respiratory failure is associated with a worse early prognosis after out-of-hospital cardiac arrest.

Risk Factors And Outcomes For Recurrent Paediatric In-Hospital Cardiac Arrest: Retrospective Multicenter Cohort Study

Resuscitation ◽  
2021 ◽  
Author(s):  
Maria E. Frazier ◽  
Stephanie R Brown ◽  
Amanda O'Halloran ◽  
Tia Raymond ◽  
Richard Hanna ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Arrest ◽  
Cohort Study ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort ◽  
Hospital Cardiac Arrest

Patients With Idiopathic Pulmonary Fibrosis Admitted to the ICU With Acute Respiratory Failure—A Reevaluation of the Risk Factors and Outcomes

2021 ◽  
pp. 088506662198924
Author(s):  
Matthew Schrader ◽  
Matheni Sathananthan ◽  
Niranjan Jeganathan
Keyword(s):  
Risk Factors ◽  
Respiratory Failure ◽  
Mortality Rate ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Acute Respiratory Failure ◽  
Small Sample ◽  
Apache Score ◽  
Non Invasive ◽  
Organ Failures

Introduction: Idiopathic pulmonary fibrosis (IPF) patients admitted to the ICU with acute respiratory failure (ARF) are known to have a poor prognosis. However, the majority of the studies published to date are older and had small sample sizes. Given the advances in ICU care since the publication of these studies, we sought to reevaluate the outcomes and risk factors associated with mortality in these patients. Methods: Retrospective study using a large multi-center ICU database. We identified 411 unique patients with IPF admitted with ARF between 2014-2015. Results: Of all IPF patients admitted to the ICU with ARF, 81.3% required mechanical ventilation (MV): 48.9% invasive and 32.4% non-invasive alone. The hospital mortality rate was 34.5% for all patients; 48.8% in patients requiring invasive MV, 21.8% in those requiring non-invasive MV and 19.5% with no MV. In multiple regression analyses, age, APACHE score, invasive MV, and hyponatremia at admission were associated with increased mortality whereas post-op status was associated with lower mortality. In patients requiring invasive MV, baseline PaO2/FiO2 ratio was also predictive of mortality. Non-pulmonary organ failures were present in less than 20% of the patients. Conclusions: Although the overall mortality rate for IPF patients admitted to the ICU with ARF has improved, the mortality rates for patients requiring invasive MV remains high at approximately 50%. Older age, high APACHE score, and low baseline PaO2/FiO2 ratio are factors predictive of increased mortality in this population.

scholarly journals Thromboelastometric analysis of the risk factors for return of spontaneous circulation in adult patients with out-of-hospital cardiac arrest

PLoS ONE ◽  
2017 ◽  
Vol 12 (4) ◽  
pp. e0175257 ◽  
Author(s):  
Hiroyuki Koami ◽  
Yuichiro Sakamoto ◽  
Ryota Sakurai ◽  
Miho Ohta ◽  
Hisashi Imahase ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Arrest ◽  
Spontaneous Circulation ◽  
Adult Patients ◽  
Return Of Spontaneous Circulation ◽  
Hospital Cardiac Arrest
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