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Original Research

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Prognostic factors for adults with cardiac arrest in the emergency department: a retrospective cohort study

  • Po-Cheng Chen1,2,†
  • Jen-Hao Chen1,†
  • Chung-Cheng Yeh1
  • Chia-Hau Chang2
  • Chi-Chun Lin3,4
  • Chip-Jin Ng3
  • Chen-June Seak2,3
  • Li-Heng Tsai3
  • Cheng-Yu Chien3,4,5

1Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung Branch, 333 Taoyuan, Taiwan

2Department of Emergency Medicine, New Taipei Municipal Tucheng Hospital, 236 New Taipei City, Taiwan

3Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, 333 Taoyuan, Taiwan

4Department of Emergency Medicine, Ton-Yen General Hospital, 302 Zhubei, Taiwan

5Graduate Institute of Management, Chang Gung University, 333 Taoyuan, Taiwan

DOI: 10.22514/sv.2021.239

Submitted: 18 September 2021 Accepted: 09 November 2021

Online publish date: 08 December 2021

*Corresponding Author(s): Li-Heng Tsai E-mail: lihan0509@gmail.com
*Corresponding Author(s): Cheng-Yu Chien E-mail: rainccy217@gmail.com

† These authors contributed equally.

Abstract

Cardiac arrest in the emergency department is associated with the following three scenarios: out-of-hospital cardiac arrest, primary emergency department cardiac arrest (EDCA), and patients transferred from other hospitals after the return of spontaneous circulation from cardiac arrest. Among them, the primary cardiac arrest episode in the emergency department has been less studied. This aim of this study was to explore patient characteristics and the relationship between causes of EDCA and survival outcomes according to different patient management strategies. The main finding of this study was that EDCA with Cardiogenic etiology was associated with higher survival to discharge (OR: 2.31; 95% CI: 1.59–3.91) and discharged neurological outcome (OR: 2.84; 95% CI: 1.57–5.97). More favorable discharged neurological outcome were also found in EDCA patients with initial shockable rhythm (OR: 4.83; 95% CI: 2.33–10.01) and shorter resuscitation time (≤11.5 min, OR: 3.62; 95% CI: 1.57–8.32). EDCA patients under sedative medication (OR: 0.24; 95% CI: 0.10–0.59) and ventilator support by intubation before EDCA episode (OR: 0.26; 95% CI: 0.09–0.75) had poor neurological outcome. We conclude that EDCA patients with cardiogenic etiology have more favorable survival to discharge and discharged neurological outcomes. Prolonged CPR time during EDCA, post-intubation status and sedative medication use were prognostic factors of negative survival and neurological outcomes.


Keywords

Cardiac arrest; Emergency department; Cardiopulmonary resuscitation; Cerebral performance category


Cite and Share

Po-Cheng Chen,Jen-Hao Chen,Chung-Cheng Yeh,Chia-Hau Chang,Chi-Chun Lin,Chip-Jin Ng,Chen-June Seak,Li-Heng Tsai,Cheng-Yu Chien. Prognostic factors for adults with cardiac arrest in the emergency department: a retrospective cohort study. Signa Vitae. 2022.doi:10.22514/sv.2021.239.

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