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J Korean Soc Emerg Med > Volume 34(5); 2023 > Article
Journal of The Korean Society of Emergency Medicine 2023;34(5): 383-393.
응급실 재실 중 발생한 심정지 환자의 생존 퇴원과 관련한 요인분석
정종희1 , 류지호1,2 , 민문기1,2 , 이대섭1 , 천모세1 , 현태규1 , 이민지1
1양산부산대학교병원 응급의학과
2부산대학교 의과대학 응급의학교실
Analysis of the factors associated with survival to hospital discharge in adult patients with cardiac arrest in the emergency department
Jonghee Jung1 , Ji Ho Ryu1,2 , Mun Ki Min1,2 , Daesup Lee1 , Mose Chun1 , Taegyu Hyun1 , Minjee Lee1
1Department of Emergency Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
2Department of Emergency Medicine, Pusan National University College of Medicine, Busan, Korea
Correspondence  Minjee Lee ,Tel: 055-30-2143, Fax: 055-360-2173, Email: liobamj@gmail.com,
Received: September 29, 2022; Revised: October 17, 2022   Accepted: October 19, 2022.  Published online: October 31, 2023.
There is limited data on the outcomes of cardiac arrest occurring in emergency departments (ED). The objective of this study was to identify the factors associated with these outcomes, primarily the survival to hospital discharge and the neurological status at discharge in emergency department cardiac arrest (EDCA) patients.
A retrospective study was conducted in a tertiary hospital. Adult patients aged over 18 years who had suffered an in-hospital cardiac arrest in the ED between July 2018 to June 2021 were included. The primary outcome was the survival to hospital discharge. Descriptive statistics and logistic regression analyses were performed.
We identified 157 ED arrests. Among these, 57.9% of the patients died in the emergency room. A total of 24.1% obtained survival discharge. The combined existing illnesses, such as renal insufficiency or malignancy were directly related to the survival of the patients. A cardiac and respiratory cause of arrest increased the probability of survival (P<0.001). The shorter the time spent on cardiopulmonary resuscitation (CPR), the higher the chances of survival (odds ratio of 0.84). The subjects in both the survivor and deceased groups were classified as Korean Triage and Acuity Scale 2 (KTAS 2: emergency) or higher (P=0.719). There was no difference in the ED occupancy, which is an emergency room overcrowding indicator.
EDCA patients are already in a clinically deteriorated condition. The underlying clinical conditions, the cause of cardiac arrest, the initial rhythm, and the CPR duration time are directly related to the patient’s chances of survival and prognoses. Therefore, it is possible to identify these factors at an early stage and take the appropriate management measures.
Key words: Cardiopulmonary resuscitation; Early Warning Score; Critical care outcomes
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