• Rachel Aguma Alum, Joseph Kyobe Kiwanuka, Doreen Nakku, Elijah Ronald Kakande, Victoria Nyaiteera, and Stephen Senyonjo Ttendo.
• From the Departments of Anaesthesia and Critical Care.
• Anesth. Analg. 2022 Nov 1; 135 (5): 107310811073-1081.

BackgroundCardiac arrest (CA) is still associated with high mortality and morbidity across all practice settings despite resuscitation attempts and advancements in its management. Patient outcomes vary and are affected by multiple factors. Nonetheless, there is a paucity of information on survival after CA and associated factors in low-resource settings such as East Africa where Uganda is located. This study set out to describe post-CA survival, associated factors, and neurological outcome at a hospital in Southwestern Uganda.MethodsThis was a descriptive study in which we followed up with resuscitated CA patients from any of the selected hospital locations at Mbarara Regional Referral Hospital in Southwestern Uganda. We included all patients who were resuscitated after an index CA in the operating room (OR), intensive care unit (ICU), the pediatric ward, or accident and emergency (A&E) wards. Details of resuscitation were obtained from resuscitation team leader interviews and patient medical records. We followed up with patients with return of spontaneous circulation (ROSC) for up to 7 days after CA when neurological outcomes were measured using the age-appropriate Cerebral Performance Category (CPC) score. Factors affecting survival were then determined.ResultsA total of 74 participants were enrolled over 8 months. Seven-day survival was 14.86%. Eight of the 11 survivors had a CPC score of 1 seven days after CA. Admission with trauma was associated with increased mortality with an adjusted hazard ratio (HR) of 4.06; 95% confidence interval (CI), 1.19-13.82. Compared to the A&E ward, HR for index CA in OR, ICU, and pediatric ward was 0.15; 95% CI, 0.05-0.45; 0.67; 95% CI, 0.32-1.40, and 0.65; 95% CI, 0.25-1.69, respectively. Compared to cardiopulmonary resuscitation (CPR) <10 minutes, the HR for CPR duration between 10 and 20 minutes was 2.26; 95% CI, 0.78-3.24 and for >20 minutes was 2.26; 95% CI, 1.12-4.56. Prevention of hypotension after ROSC was associated with decreased mortality with an HR of 0.23; 95% CI, 0.08-0.58.ConclusionsWhereas 7-day survival of resuscitated CA patients at Mbarara Regional Referral Hospital (MRRH) was low, survivors had a good neurologic outcome. CA in the OR, CPR <20 minutes, and prevention of hypotension postarrest seemed to be associated with survival.Copyright © 2022 International Anesthesia Research Society.

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