Journal of Acute Care

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VOLUME 2 , ISSUE 1 ( January-April, 2023 ) > List of Articles

Original Article

Outcome of Cardiac Arrest in a Tertiary Care Urban Hospital in India

Krunalkumar J Patel, Anuj M Clerk, Nikita Desai

Keywords : Cardiac arrest, Cardiopulmonary resuscitation, In-hospital cardiac arrest, Out-of-hospital cardiac arrest, Registry, Survival

Citation Information : Patel KJ, Clerk AM, Desai N. Outcome of Cardiac Arrest in a Tertiary Care Urban Hospital in India. 2023; 2 (1):4-9.

DOI: 10.5005/jp-journals-10089-0059

License: CC BY-NC 4.0

Published Online: 23-08-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Introduction: Survival from cardiac arrest (CA) remains poor and for meaningful research in India, one needs to first standardize treatment and documentation, before multicentric data can be pooled to create a large database. The arrest outcome consortium (AOC) online Registry (www.aocregistry.com) is an online database created for the same. Initial analysis of single center data is presented here as a test of its functionality. Materials and methods: This is a retrospective observational study of cardiopulmonary resuscitation (CPR) data from 200-bed, urban hospitals for the year 2018. Data were collected in a standardized format, uploaded, and analyzed on the AOC registry web portal. Descriptive statistics were downloaded from the portal and statistical analysis was done by using statistical package for the social science (SPSS) software. Results: Out of 127 CAs, 111 received CPR [30 out-of-hospital CAs (OHCAs), 81 in-hospital CAs (IHCAs)]. The average age, equally in both genders was 57 years. The bystander CPR rate among OHCA was 6.7%. Pulseless Electrical Activity (PEA) was the most common first rhythm [58(52.2%)], followed by asystole [40(36%)] and ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) [13(11.7%)]. At discharge16.2% (18 of 111) were alive and 14.4% (16) had good [cerebral performance category (CPC) ≤2] neurological status. There was no significant difference in survival between males (12.8%) and females (21.9%) (p = 0.161). The best neurological survival was with VF/pVT as the first rhythm. Multivariate regression analysis showed first rhythm and admission lactate influence return of spontaneous circulation (ROSC) and first rhythm influences survival at discharge. Out of 18 survivors at discharge, 10 were alive, five died and three lost to follow-up, both at 6 and 12 months. Conclusion: Survival at discharge was more with VF/pVT as the first rhythm. AOC registry portal could provide descriptive statistics, which can be used for inferential analysis. A large sample size is required for statistical analysis among subgroups.


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