Analysis of the factors associated with survival to hospital discharge in adult patients with cardiac arrest in the emergency department

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.

ABSTRACT

Objective:
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.
Method:
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.
Results:
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.
Conclusion:
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