• Clotilde Bailleul, Etienne Puymirat, Phillipe Aegerter, Bertrand Guidet, Emmanuel Guerot, Jean-Loup Augy, Nicolas Brechot, Jean-Luc Diehl, Jean-Yves Fagon, Bertrand Hermann, Ana Novara, Sofia Ortuno, Romy Younan, Nicolas Danchin, Alain Cariou, and Nadia Aissaoui.
• Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Intensive Care Unit, Université de Paris, Paris, France.
• J Crit Care. 2022 Jun 1; 69: 154003.

BackgroundIn-hospital cardiac arrest(IHCA) has received little attention compared with out-of-hospital cardiac arrest.AimTo address the paucity of data on IHCA patients, we examined key features, variations in mortality and predictors of death among patients admitted in French intensive care units(ICUs) from 1997 to 2015.MethodsUsing the database of the Collège des Utilisateurs de Bases de données en Réanimation(CUB-Réa) that prospectively collects data from ICUs in the greater Paris area, we determined temporal trends in the incidence of IHCA, patients' outcomes, crude and Simplified Acute Physiology Score(SAPS)-II Standardized mortality and predictors of in-ICU mortality.ResultsOf the 376,325 ICU admissions, 15,324(4.08%) had IHCA, with incidence increasing from 2.78% to 3.83%(p < 0.001). Over time, the patient age increased by 0.7 years(p = 0.04) and SAPS-II increased by 2.3%(p < 0.001). Crude in-ICU mortality decreased from 78% to 62.5% over the past 18 years(p < 0.001). The SAPS-II-standardized mortality also decreased over time from 78.4% to 68.3%(p < 0.001) representing a 10.1% relative decrease from 1997 to 2015. In multivariate analysis, admission in a more recent time-period was an independent correlate of decreased mortality(OR 0.40, 95%CI 0.35-0.46).ConclusionOccurrence of IHCA increased over time but remains an uncommon reason for being admitted to ICU. From 1997 to 2015, we observed a change in patient profile, with older and more critically ill patients, despite which in-ICU mortality has substantially decreased in IHCA patients, likely resulting from a global improvement in the process of care and more widespread implementation of rapid response teams.Copyright © 2022 Elsevier Inc. All rights reserved.

11 keywords...

hide…