tetano
Editor, Senior Moderator
Crit Care Explor
. 2021 May 14;3(5):e0425.
doi: 10.1097/CCE.0000000000000425. eCollection 2021 May.
A Multicenter Evaluation of Survival After In-Hospital Cardiac Arrest in Coronavirus Disease 2019 Patients
Abhishek Bhardwaj[SUP] 1 [/SUP], Mahmoud Alwakeel[SUP] 2 [/SUP], Talha Saleem[SUP] 2 [/SUP], Saira Afzal[SUP] 2 [/SUP], Sura Alqaisi[SUP] 2 [/SUP], Aisha R Saand[SUP] 2 [/SUP], Hanan Al Najjar[SUP] 2 [/SUP], Lori Griffiths[SUP] 3 [/SUP], Xiaozhen Han[SUP] 4 [/SUP], Xiaofeng Wang[SUP] 4 [/SUP], Silvia Perez-Protto[SUP] 5 6 [/SUP], Benjamin S Abella[SUP] 7 [/SUP], David F Gaieski[SUP] 8 [/SUP], Abhijit Duggal[SUP] 1 8 [/SUP], Francois Abi Fadel[SUP] 1 8 [/SUP]
Affiliations
Abstract
Importance: In-hospital cardiac arrest survival among coronavirus disease 2019 patients has been reported to range from 0% to 12%. These numbers are significantly lower than reported prepandemic in-hospital cardiac arrest survival rates of approximately 20-25% in the United States for non-coronavirus disease 2019 patients.
Objective: To assess the incidence of in-hospital cardiac arrest survival of coronavirus disease 2019 patients.
Design: A retrospective cohort study of adult patients with coronavirus disease 2019 subsequently found to have in-hospital cardiac arrest and underwent cardiopulmonary resuscitation (cardiopulmonary resuscitation).
Setting: Multiple hospitals of the Cleveland Clinic Health System.
Patients: All adult patients (age ≥ 18 yr) admitted to Cleveland Clinic Health System with a diagnosis of coronavirus disease 2019 who experienced in-hospital cardiac arrest requiring cardiopulmonary resuscitation.
Measurements and main results: From March 01, 2020 to October 15, 2020, 3,555 patients with coronavirus disease 2019 were hospitalized; 1,372 were admitted to the ICU; 58 patients had in-hospital cardiac arrest. Median age of this cohort was 66.5 years (interquartile range, 55.0-76.0 yr). Patients were predominantly male (62.5%), White (53.4%), with a median body mass index of 29.7 (interquartile range, 25.8-34.6). Most in-hospital cardiac arrests were in critical care environments (ICU), 51 of 58 (87.9%); seven of 58 (12.1%) were on ward locations. Thirty-four of 58 patients (58.6%) were on mechanical ventilation prior to in-hospital cardiac arrest with a median duration of mechanical ventilation of 9 days (interquartile range, 2-18 d). Twenty-four of 58 patients (44%) were on vasopressors prior to arrest. Initial arrest rhythm was pulseless electrical activity at (63.8%), asystole (29.3%), and pulseless ventricular tachycardia/fibrillation (6.9%). Of the 58 patients, 35 (60.3%) attained return of spontaneous circulation, and 13 of 58 (22.4%) were discharged alive.
Conclusions: We report a 22% survival to discharge after in-hospital cardiac arrest in coronavirus disease 2019 patients, a survival rate similar to before the coronavirus disease 2019 pandemic.
Keywords: cardiac arrest; cardiopulmonary resuscitation; coronavirus disease 2019; resuscitation; severe acute respiratory syndrome coronavirus 2; survivorship.
. 2021 May 14;3(5):e0425.
doi: 10.1097/CCE.0000000000000425. eCollection 2021 May.
A Multicenter Evaluation of Survival After In-Hospital Cardiac Arrest in Coronavirus Disease 2019 Patients
Abhishek Bhardwaj[SUP] 1 [/SUP], Mahmoud Alwakeel[SUP] 2 [/SUP], Talha Saleem[SUP] 2 [/SUP], Saira Afzal[SUP] 2 [/SUP], Sura Alqaisi[SUP] 2 [/SUP], Aisha R Saand[SUP] 2 [/SUP], Hanan Al Najjar[SUP] 2 [/SUP], Lori Griffiths[SUP] 3 [/SUP], Xiaozhen Han[SUP] 4 [/SUP], Xiaofeng Wang[SUP] 4 [/SUP], Silvia Perez-Protto[SUP] 5 6 [/SUP], Benjamin S Abella[SUP] 7 [/SUP], David F Gaieski[SUP] 8 [/SUP], Abhijit Duggal[SUP] 1 8 [/SUP], Francois Abi Fadel[SUP] 1 8 [/SUP]
Affiliations
- PMID: 34036276
- PMCID: PMC8133239
- DOI: 10.1097/CCE.0000000000000425
Abstract
Importance: In-hospital cardiac arrest survival among coronavirus disease 2019 patients has been reported to range from 0% to 12%. These numbers are significantly lower than reported prepandemic in-hospital cardiac arrest survival rates of approximately 20-25% in the United States for non-coronavirus disease 2019 patients.
Objective: To assess the incidence of in-hospital cardiac arrest survival of coronavirus disease 2019 patients.
Design: A retrospective cohort study of adult patients with coronavirus disease 2019 subsequently found to have in-hospital cardiac arrest and underwent cardiopulmonary resuscitation (cardiopulmonary resuscitation).
Setting: Multiple hospitals of the Cleveland Clinic Health System.
Patients: All adult patients (age ≥ 18 yr) admitted to Cleveland Clinic Health System with a diagnosis of coronavirus disease 2019 who experienced in-hospital cardiac arrest requiring cardiopulmonary resuscitation.
Measurements and main results: From March 01, 2020 to October 15, 2020, 3,555 patients with coronavirus disease 2019 were hospitalized; 1,372 were admitted to the ICU; 58 patients had in-hospital cardiac arrest. Median age of this cohort was 66.5 years (interquartile range, 55.0-76.0 yr). Patients were predominantly male (62.5%), White (53.4%), with a median body mass index of 29.7 (interquartile range, 25.8-34.6). Most in-hospital cardiac arrests were in critical care environments (ICU), 51 of 58 (87.9%); seven of 58 (12.1%) were on ward locations. Thirty-four of 58 patients (58.6%) were on mechanical ventilation prior to in-hospital cardiac arrest with a median duration of mechanical ventilation of 9 days (interquartile range, 2-18 d). Twenty-four of 58 patients (44%) were on vasopressors prior to arrest. Initial arrest rhythm was pulseless electrical activity at (63.8%), asystole (29.3%), and pulseless ventricular tachycardia/fibrillation (6.9%). Of the 58 patients, 35 (60.3%) attained return of spontaneous circulation, and 13 of 58 (22.4%) were discharged alive.
Conclusions: We report a 22% survival to discharge after in-hospital cardiac arrest in coronavirus disease 2019 patients, a survival rate similar to before the coronavirus disease 2019 pandemic.
Keywords: cardiac arrest; cardiopulmonary resuscitation; coronavirus disease 2019; resuscitation; severe acute respiratory syndrome coronavirus 2; survivorship.