Survival and functional outcome at hospital discharge following in-hospital cardiac arrest (IHCA): A prospective multicentre observational study.

Abstract

To evaluate the functional outcome of patients after in-hospital cardiac arrest (IHCA) and to identify associations with good functional outcome at hospital discharge. Emergency calls were prospectively screened and data collected for IHCAs in seven Australian hospitals. Patients were included if aged>18 years, admitted as an acute care hospital in-patient and experienced IHCA; defined by a period of unresponsiveness with no observed respiratory effort and commencement of external cardiac compressions. Data collected included patient demographics, clinical and cardiac arrest characteristics, survival and functional outcome at hospital discharge using the modified Rankin Scale (mRS) and Katz Index of Independence in ADLs (Katz-ADL). 152 patients suffered 159 IHCAs (male 66.4%; mean age 70.2 (± 13.9) years). Sixty patients (39.5%) survived, of whom 43 (71.7%) had a good functional outcome (mRS 0 3) and 38 (63.3%) were independent with activities of daily living (ADLs) at hospital discharge (Katz-ADL0=06). Younger age (OR 0.95; 95% CI 0.91-0.98; p0=00.003), shorter duration of CPR (OR 0.84; 95% CI 0.77-0.91; p0<00.0001) and shorter duration of hospital admission prior to IHCA (OR 0.96; 95% CI 0.93-0.998; p=0.04) were independently associated with a good functional outcome at hospital discharge. The majority of survivors had a good functional outcome and were independent with their ADLs at hospital discharge. Factors associated with good functional outcome at hospital discharge were identified.