Prognostic factors for adults with cardiac arrest in the emergency department: a retrospective cohort study
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 Vol.18,Issue 3,May 2022 pp.56-64
Submitted: 18 September 2021 Accepted: 09 November 2021
Published: 08 May 2022
† These authors contributed equally.
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.
Cardiac arrest; Emergency department; Cardiopulmonary resuscitation; Cerebral performance category
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