Outcome of In-hospital Cardiac Arrest And Its Relation To Quality of Cardiopulmonary Resuscitation

Abstract

Introduction: Cardiopulmonary resuscitation (CPR) is a lifesaving intervention and the cornerstone of resuscitation from cardiac arrest and when performed according to the international guidelines has a vital impact on survival of cardiac arrest (CA). The Utstein template (UT) has been used internationally to objectively evaluate different variables of CPR quality and outcome. Objective: Determine outcomes of cardiopulmonary resuscitation (CPR) in the form of return of spontaneous circulation (ROSC) and survival to hospital discharge in Maadi Military hospital also to determine adherence to evidence-based CPR guidelines.  . Methods: A prospective observational study of 134 IHCA from 1st of December 2012 and through May 2013 out of 3498 patients admitted in the different departments at Maddi Military hospital, using a modified UT. Results: CPR was attempted in 129 cases (96.3%) the remaining 5 cases one of them was found dead and the other 4 were considered futile . CA was witnessed in 124 (92.5%) and monitored in 114 cases (85.1%) .The initial rhythm was brady-asystole in 98 cases (73.1%) brady-asystole 98 cases (73.1%) and PEA in 3% 0f cases. ROSC was achieved in 54 cases (41.9%). Survival to hospital discharge (STHD) was achieved in 22 cases (16.4%); none of them had neurologic deficit. Conclusion: The survival rate to hospital discharge was appropriate (16.4%) compared to other studies.ROSC was achieved in 41.9% of cases which was almost equivalent to other studies Relatively poor post cardiac arrest care (eg. no therapeutic hypothermia) Monitored arrest, 1st responder CPR, time interval from collapse and 1st DC shock were independent predictors of ROSC. Monitored arrest 1st responder CPR, shockable rhythm and age were predictors of survival Keywords: in- hospital cardiac arrest, cardiopulmonary resuscitation, ROSC