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J Korean Soc Emerg Med > Volume 21(6); 2010 > Article
Journal of The Korean Society of Emergency Medicine 2010;21(6): 749-756.
Prognosis of In-Hospital Cardiac Arrest and Severe Comorbidities
Shin Nyum Kim, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Hyoung Gon Song
Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea. cprking@skku.edu
The purpose of our study was to evaluate the relevance of a patient's critical comorbidities to his survival rate, along with factors that influence the prognosis of patients who went through in-hospital cardiac arrest. We also investigated the association between the physical burden of the patients' comorbidities and the prognosis of inhospital arrest patients using the Deyo-Charlson score.
We retrospectively reviewed data for 1,094 patients with in-hospital cardiopulmonary arrest between January 2003 and June 2009 according to the Utstein-style guidelines. Severe comorbidities included congestive heart disease, chronic renal failure, severe liver disease, pulmonary disease, and hematologic or metastatic solid malignancy. Multivariate Cox regression analysis and logistic regression models were used to assess the hazard ratio and survival factors.
The hazard ratio of patients with severe liver disease or hematologic or metastatic solid cancer were 1.42 (95% CI, 1.14-1.76, p=0.002) and 1.60 (95% CI, 1.36-1.88, p<0.001), respectively. Shorter CPR duration and subsequent intervention were significant prognostic factors in patients with severe comorbidities. The Deyo-Charlson score was one of the independent prognostic factors in the overall study population.
The six month survival rate of patients with a history of severe liver disease or hematologic or solid metastatic cancer that underwent in-hospital cardiac arrest is low.
Key words: Heart arrest, Cardiopulmonary resuscitation, Comorbidity, Mortality
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