Analysis of characteristics and trends of the In-Hospital Cardiac Arrest incidence in the Republic of Korea: clinical usefulness of national health insurance claim data
1Department of Emergency Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, 49201, Republic of Korea
DOI: 10.22514/sv.2021.047 Vol.17,Issue 3,May 2021 pp.196-205
Submitted: 27 January 2021 Accepted: 23 February 2021
Published: 08 May 2021
Backgrounds: In-Hospital Cardiac Arrest (IHCA) requires the preparation of considerable medical resources in hospitals. Furthermore, compared to Out-of-Hospital Cardiac Arrest, until recently, there have not been many studies on the incidence, characteristics, and prognosis of IHCA. This study is to examine IHCA event rates among hospitalized patients in the Republic of Korea from 2011 to 2015.
Methods: The incidence of IHCA in adults was extracted from claim data of the National Health Insurance Service from 2011 to 2015, and analyzed according to age, sex, the classification under the 7th revision of the Korean Standard Classification of Diseases (KCD-7), hospital types, and provinces.
Results: From 2011 to 2015, the overall incidence of IHCA in Korea was founded to be 3.00 per 1,000 hospitalizations. The overall 5-year IHCA incidence was higher in male at 3.92 cases per 1,000 hospitalizations and at female 2.19 cases per 1,000 hospitalizations. Incidence due to cardiovascular disease increased year by year, whereas incidences due to respiratory, neurological and infectious disease were decreasing, and in the case of oncologic disease, there was no change. In particular, patients with diseases of the circulatory system had at least a two times higher incidence compared to those with other diseases. The IHCA incidence in general hospitals and tertiary hospitals was at least two-fold higher than the national overall and showed an increasing trend. The provinces that showed a higher IHCA incidence than the five-year national overall were Jeju Special Self-Governing Province, Gangwon Province, and Seoul.
Conclusions: The results of this study can be used as important basic data to secure patient safety by reducing the occurrence of IHCA.
In-Hospital Cardiac Arrest; Incidence; Epidemiology; Big data; Claim data
In Ho Kwon,Yuri Choi. Analysis of characteristics and trends of the In-Hospital Cardiac Arrest incidence in the Republic of Korea: clinical usefulness of national health insurance claim data. Signa Vitae. 2021. 17(3);196-205.
 Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics-2014 update: a report from the American Heart Association. Circulation. 2014; 129: e28-e292.
 Sandroni C, Nolan J, Cavallaro F, Antonelli M. In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intensive Care Medicine. 2007; 33: 237-245.
 Idris AH, Bierens JJLM, Perkins GD, Wenzel V, Nadkarni V, Morley P, et al. 2015 revised Utstein-style recommended guidelines for uniform reporting of data from drowning-related resuscitation: an ILCOR advisory statement. Resuscitation. 2017; 118: 147-158.
 Krishna CK, Showkat HI, Taktani M, Khatri V. Out of hospital cardiac arrest resuscitation outcome in North India - CARO study. World Journal of Emergency Medicine. 2017; 8: 200-205.
 Monsieurs KG, Nolan JP, Bossaert LL, Greif R, Maconochie IK, Nikolaou NI, et al. European Resuscitation Council Guidelines for resuscitation 2015: section 1. Executive summary. Resuscitation. 2015; 95: 1-80.
 Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, et al. Part 1: executive summary: 2015 American Heart Association Guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015; 132: S315-S367.
 Sinha SS, Sukul D, Lazarus JJ, Polavarapu V, Chan PS, Neumar RW, et al. Identifying important gaps in randomized controlled trials of adult cardiac arrest treatments: a systematic review of the published literature. Circulation: Cardiovascular Quality and Outcomes. 2016; 9: 749-756.
 Andersen LW, Holmberg MJ, Berg KM, Donnino MW, Granfeldt A. In-hospital cardiac arrest: a review. Journal of the American Medical Association. 2019; 321: 1200-1210.
 Andersen LW, Holmberg MJ, Løfgren B, Kirkegaard H, Granfeldt A. Adult in-hospital cardiac arrest in Denmark. Resuscitation. 2019; 140: 31- 36.
 Merchant RM, Yang L, Becker LB, Berg RA, Nadkarni V, Nichol G, et al. Incidence of treated cardiac arrest in hospitalized patients in the United States. Critical Care Medicine. 2011; 39: 2401-2406.
 Morrison LJ, Neumar RW, Zimmerman JL, Link MS, Newby LK, McMullan PW, et al. Strategies for improving survival after in-hospital cardiac arrest in the United States: 2013 consensus recommendations: a consensus statement from the American Heart Association. Circulation. 2013; 127: 1538-1563.
 Harrison DA, Patel K, Nixon E, Soar J, Smith GB, Gwinnutt C, et al. Development and validation of risk models to predict outcomes following in-hospital cardiac arrest attended by a hospital-based resuscitation team. Resuscitation. 2014; 85: 993-1000.
 Nam DJ, Kwon HW, Lee H, Ahn EK. National healthcare service and its big data analytics. Healthcare Informatics Research. 2018; 24: 247-249.
 Choi Y, Kwon IH, Jeong J, Chung J, Roh Y. Incidence of Adult in-hospital cardiac arrest using national representative patient sample in Korea. Healthcare Informatics Research. 2016; 22: 277-284.
 Kwon IH. In-hospital cardiac arrest incidence analysis using claim data in Korea. Kangwon, Republic of Korea: Graduate school, Kangwon National University. 2019.
 Nolan JP, Soar J, Smith GB, Gwinnutt C, Parrott F, Power S, et al. Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit. Resuscitation. 2014; 85: 987-992.
 Thompson LE, Chan PS, Tang F, Nallamothu BK, Girotra S, Perman SM, et al. Long-term survival trends of medicare patients after in-hospital cardiac arrest: insights from get with the guidelines-resuscitation®. Resuscitation. 2018; 123: 58-64.
 Radeschi G, Mina A, Berta G, Fassiola A, Roasio A, Urso F, et al. Incidence and outcome of in-hospital cardiac arrest in Italy: a multicentre observational study in the Piedmont Region. Resuscitation. 2017; 119: 48- 55.
 Shao F, Li CS, Liang LR, Qin J, Ding N, Fu Y, et al. Incidence and outcome of adult in-hospital cardiac arrest in Beijing, China. Resuscitation. 2016; 102: 51-56.
 Aziz F, Paulo MS, Dababneh EH, Loney T. Epidemiology of in-hospital cardiac arrest in Abu Dhabi, United Arab Emirates, 2013-2015. Heart Asia. 2018; 10: e011029.
 Chan PS, Nallamothu BK, Krumholz HM, Spertus JA, Li Y, Hammill BG, et al. Long-term outcomes in elderly survivors of in-hospital cardiac arrest. New England Journal of Medicine. 2013; 368: 1019-1026.
 Perman SM, Stanton E, Soar J, Berg RA, Donnino MW, Mikkelsen ME, et al. Location of in-hospital cardiac arrest in the United States-variability in event rate and outcomes. Journal of the American Heart Association. 2016; 5: e003638.
 Tirkkonen J, Hellevuo H, Olkkola KT, Hoppu S. Aetiology of in-hospital cardiac arrest on general wards. Resuscitation. 2016; 107: 19-24.
 Wallmuller C, Meron G, Kurkciyan I, Schober A, Stratil P, Sterz F. Causes of in-hospital cardiac arrest and influence on outcome. Resuscitation. 2012; 83: 1206-1211.
 Merchant RM, Berg RA, Yang L, Becker LB, Groeneveld PW, Chan PS. Hospital variation in survival after in-hospital cardiac arrest. Journal of the American Heart Association. 2014; 3: e000400.
 Yun SB, Kim S, Ju S, Noh J, Kim C, Wong MS, et al. Analysis of accessibility to emergency rooms by dynamic population from mobile phone data: geography of social inequity in South Korea. PLoS ONE. 2020; 15: e0231079.
 Lyons PG, Edelson DP, Churpek MM. Rapid response systems. Resuscitation. 2018; 128: 191-197.
 Kwon J, Lee Y, Lee Y, Lee S, Park J. An algorithm based on deep learning for predicting In‐Hospital Cardiac Arrest. Journal of the American Heart Association. 2018; 7: e008678.
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.
IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.
Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.
Scopus: CiteScore 0.5(2019) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.