A prospective observational study on initial rhythm during cardiac arrest versus outcome

Abstract

Background: In-hospital cardiac arrest (IHCA) is a major cause of death among patients. Extensive research has been performed regarding out-of-hospital cardiac arrest (OHCA), and efforts to improve prognosis have led to a dramatic increase in survival. However, IHCA has not been widely studied, and even basic data, such as incidence, has only been covered in a few reports. Research on cardiac arrest and cardiopulmonary resuscitation (CPR) has considerably increased in recent decades, and international guidelines for resuscitation have been implemented and have undergone several changes. Objectives: To determine the association of initial rhythm and various factors during IHCA with outcome Material and Methods: All Adult IHCA patients were included in the study. Study was conducted from June 2022 to March 2023 over 208 patients. Data is collected from the CPR forms of the patients and the survived patients are followed up till discharge. Data was analyzed with descriptive statistical tools.
Results and Conclusion: 208 IHCA patients were taken up for study. Incidence of IHCA is 8.1 per 1000 hospital admissions. In all age groups Males are more than Females. Sepsis is one of the causes of arrest in 44%, CAD (35%), CLD (11.5%) and cancer (8.1%). Though rate of survival to hospital discharge is more after VT as initial rhythm than Asystole/PEA, there is no statistically significant association
between initial rhythm and 24hr survival, 48 hr survival, 72 hr survival and survival to hospital discharge. Though CAD was one of the causes of cardiac arrest in 64% of 24hr survival post CPR and 71.4% of survival to hospital discharge patients, the association of it with survival to hospital discharge is not statistically significant. The association of no. of doses of adrenaline given during IHCA is
statistically significant with both hospital stay post CPR and survival to hospital discharge. Rate of survival to hospital discharge is 3.37% and it is more in females compared to males.