Highlights
- •Multiple code patients had higher in-hospital mortality
- •Multiple codes within 24 hours led to significantly higher in-hospital mortality
- •Patients sustaining a neurologic event were more likely to have a non-home discharge
Abstract
Background
Cardiopulmonary resuscitation (CPR) is widely used in response to cardiac arrest.
However, little is known regarding outcomes for those who undergo multiple episodes
of cardiac arrest while in the hospital.
Objectives
The purpose of this study was to evaluate the association of multiple cardiac events
with in-hospital mortality for patients admitted to our tertiary care hospital who
underwent multiple code events.
Methods
We performed a retrospective cohort study on all patients who underwent cardiac arrest
from 2012 to 2016. Primary outcome was survival to discharge. Secondary outcomes included
post-cardiac-arrest neurologic events (PCANE), non-home discharge, and one-year mortality.
Results
There were 622 patients with an overall mortality rate of 78.0%. Patients undergoing
CPR for cardiac arrest once during their admission had lower in-hospital mortality
rates compared to those that had multiple (68.9% versus 91.3%, p<.01). Subset analysis of those who had multiple episodes of CPR revealed that more
than one event within a 24-hour period led to significantly higher in-hospital mortality
rates (94.7% versus 74.4%, p<.01). Other variables associated with in-hospital mortality included body mass index,
female sex, malignancy, and increased down time per code. Patients that had a non-home
discharge were more likely to have sustained a PCANE than those that were discharged
home (31.4% versus 3.9%, p<.01). A non-home discharge was associated with higher one-year mortality rates compared
to a home discharge (78.4% versus 54.3%, p=.01).
Conclusion
Multiple codes within a 24-hour period and the average time per code were associated
with in-hospital mortality in cardiac arrest patients.
Keywords
Abbreviations:
CPR (Cardiopulmonary resuscitation), ACLS (Advanced circulatory life support)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 26, 2022
Accepted:
November 22,
2022
Received in revised form:
November 18,
2022
Received:
June 13,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
