Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/19237
Title: The epidemiology of in-hospital cardiac arrests in Australia and New Zealand.
Authors: Fennessy, G;Hilton, Andrew K;Radford, Samuel T;Bellomo, Rinaldo;Jones, Daryl A
Affiliation: Intensive Care Unit, Western Health, Melbourne, Victoria, Australia
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Issue Date: Oct-2016
Citation: Internal Medicine Journal 2016; 46(10): 1172-1181
Abstract: The epidemiology of in-hospital cardiac arrests (IHCA) in Australia and New Zealand (ANZ) has not been systematically assessed. To conduct a systematic review of the frequency, characteristics and outcomes of adult IHCA in ANZ. Medline search for studies published in 1964-2014 using MeSH terms 'arrest AND hospital AND Australia', 'arrest AND hospital AND New Zealand', 'inpatient AND arrest AND Australia' and 'inpatient AND arrest AND New Zealand'. We screened 934 studies, analysed 50 and included 30. Frequency of IHCA ranged from 1.31 to 6.11 per 1000 admissions in 4 population studies and 0.58 to 4.59 per 1000 in 16 cohort studies. The frequency was 4.11 versus 1.32 per 1000 admissions in hospitals with rapid response system (RRS) compared with those without (odds ratio: 0.32; 95% confidence interval 0.28-0.37; P < 0.001). On aggregate, the initial cardiac rhythm was ventricular tachycardia/fibrillation in 31.4% (range 19.0-48.8%) in 10 studies reporting such data. On aggregate, IHCA were witnessed in 80.2% cases (three studies) and monitored patients in 53.4% cases (four studies). Details of life support were poorly documented. On aggregate, return of spontaneous circulation occurred in 46.0% of patients. Overall, 74.6% (range 59.4-77.5%) died in-hospital but survival was higher among monitored or younger patients, in those with a shockable rhythm, or during working hours. IHCA are uncommon in ANZ and three quarters die in-hospital. However, their frequency varies markedly across institutions and may be affected by the presence of RRS. Where reported, the long-term outcomes survivors appear to have acceptable neurological outcomes.
URI: http://ahro.austin.org.au/austinjspui/handle/1/19237
DOI: 10.1111/imj.13039
ORCID: 0000-0002-1650-8939
PubMed URL: 26865245
Type: Journal Article
Subjects: cardiac arrest
defibrillation
in-hospital
mortality
rapid response
Appears in Collections:Journal articles

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