Fræðigrein

Introduction: Survival after in-hospital cardiac arrest has not been previously reported in Iceland and the purpose of this study was to examine the outcomes of in-hospital resuscitation over a two year period.

Material and methods: There are resuscitation teams on each of the two campuses of the University Hospital in Reykjavik. Since the beginning of 2006, the resuscitation teams have compiled their reports in a structured form, Utstein style.

Results: During 2006 and 2007 resuscitation teams were activated on a total of 311 occasions. Of those, there was need for a full cardiopulmonary resuscitation because of cardiac arrest of in patients in 80 cases (26%). Return of spontaneous circulation was achieved or the patient survived to be transferred to the intensive care unit in 55 (69%) of the 80 cases. Survival to discharge was 33%. Survival to discharge was better if the arrest occurred between 8 AM and 4 PM during daytime (50%), than outside of regular working hours (23%, p=0.02). The survival was better if ventricular tachycardia or fibrillation was the first rhythm encountered (50%) than if the initial rhythm turned out to be asystole or pulseless electrical activity (12%, p=0.002). Those who survived resuscitation were generally younger than those who did not (p=0.002).

Conclusion: The outcomes were similar to those reported at institutions in our neighboring countries. The survival rate was lower if the cardiac arrest occurred outside of regular working hours and if ventricular tachycardia or fibrillation was the first encountered rhythm.

 

 

Table  I  General information
Age (year) median (N=76)	74 (21-92)
Males	49/77 (63%)
Length of CPR (min) median (N=74)	15 (1-120)
Time of arrest (N=80)
- Daytime (8:00-16:00)	25 (31%)
- After hours  (16:01-07:59)	55 (69%)
Location (N=67)
-General wards	41 (58%)
-Cardiac wards	26 (42%)
BLS prior to arrival of the team (N=61)	44 (72%)
Total resuscitation: 80 patients

 

Table  II.    Resuscitation at Landspitali
	Survivied	Died	p-value
Number of patients (N=80)	55 (69%)	25 (31%)
Location  (N=80)
- Cardiac wards	25	8	0,26
- General wards	30	17
Sex  (N=77)
- Male	33	15	0,98
- Female	20	9
Initial rhythm (N=80)
- VT/VF	21	1	0,002*
- Asystole/PEA	18	19
- Other/unknown	16	8
BLS prior to arrival of the team (N=61)
- No	11	5
- Yes	32	13	0,86
Time of arrest (N=80)
- Daytime (8:00-16:00)	16	9
- Evening  (16:01-07:59)	39	16	0,54
Age (yr) (N=76) median	73 (21-88)	80.5 (43-92)	0,03
Duration of CPR, median (N=74) (min)	15 (1-70)	14 (1-120)	0,69

 

Table III. Survival to discharge
	Survived	Died	p-value
Number of patients (N=67)	22 (33%)	45 (67%)
Location  (N=67)
- Cardiac wards	12	14	.07
- General wards	10	31
Sex  (N=66)
- Male	13	27	.86
- Female	9	17
Initial rhythm (N=67)
- VT/VF	9	9	.002
- Asystole/PEA	4	29
- Other/unknown	9	7
BLS performed (N=61)
- No	3	12	.11
- Yes	19	25
Time of arrest (N=67)
- 8:00-16:00	12	12	.02
- 16:01-07:59	10	33
Age (yr) (N=66) median	68,5 (34-79)	76 (21-92)	.002
Duration of CPR (min) (N=62) median	20 (1-70)	14 (1-120)	.67

 

Icel Med J 2009; 95: 509-14