A retrospective study of in‐hospital cardiac arrest

Abstract

Aim: In-hospital cardiac arrest is an important issue in health caretoday. Data regarding in-hospital cardiac arrest in Japan is limited. InAustralia and the USA, the Rapid Response System has been implemented inmany institutions and data regarding in-hospital cardiac arrest arecollected to evaluate the efficacy of the Rapid Response System. This isa multicenter retrospective survey of in-hospital cardiac arrest,providing data before implementing a Rapid Response System.Methods: Ten institutions planning to introduce a Rapid Response Systemwere recruited to collect in-hospital cardiac arrest data. TheInstitutional Review Board at each participating institution approvedthis study. Data for patients admitted at each institution from April 1,2011 until March 31, 2012 were extracted using the three keywords``closed-chest compression{''}, ``epinephrine{''}, and``defibrillation{''}. Patients under 18 years old, or who sufferedcardiac arrest in the emergency room or the intensive care unit wereexcluded.Results: A total of 228 patients in 10 institutions were identified. Theaverage age was 73 +/- 13 years. Males represented 64% of the patients(82/146). Overall survival after in-hospital cardiac arrest was 7%(16/228). Possibly preventable cardiac arrests represented 15% (33/228)of patients, with medical safety issues identified in 8% (19/228).Vital sign abnormalities before cardiac arrest were observed in 63%(138/216) of patients.Conclusions: Approximately 60% of patients had abnormal vital signsbefore cardiac arrest. These patients may have an improved clinicaloutcome by implementing a Rapid Response System.