• Am J Emerg Med · Dec 2020

    An outcome study of adult in-hospital cardiac arrests in non-monitored areas with resuscitation attempted using AED.

    • Katsuyuki Moriwaki, Tomoyuki Watanabe, Masako Yasuda, Tomoaki Katagiri, Masaya Ueki, Shigeaki Kurita, Michiyoshi Sanuki, and Yasuo M Tsutsumi.
    • Department of Anesthesiology, Critical Care and Pain Medicine, National Hospital Organization, Kure-Medical Center, Chugoku Cancer Center, Kure, Hiroshima, Japan. Electronic address: moriwaki.katsuyuki.zs@mail.hosp.go.jp.
    • Am J Emerg Med. 2020 Dec 1; 38 (12): 2524-2530.

    ObjectivesTo investigate the outcomes of patients with in-hospital cardiac arrest (IHCA) who underwent cardiopulmonary resuscitation (CPR) using an automated external defibrillator (AED) in non-monitored areas. Additionally, to detect correlated factors associated with rate of return of spontaneous circulation (ROSC) and survival rate, among collected data.MethodsThis study included 109 patients. After investigating patient characteristics and resuscitation-related factors, the correlated factors associated with ROSC rates and survival rate were analyzed using univariate and multivariate analyses.ResultsThe rate of survival to hospital discharge was 21.1%. CPR with AED performed since 2013 was associated with a higher ROSC rate (adjusted odds ratio [AOR] 3.24, 95% confidence interval [CI]: 1.21 to 9.52, p < 0.05), but not with the survival rate after ROSC. Tracheal intubation was significantly associated with a higher ROSC rate (AOR 3.62, 95% CI: 1.27 to 11.7, p < 0.05) and a lower survival rate after ROSC (hazard ratio 6.6, 95% CI: 1.2 to 43.3, p < 0.05). Dysrhythmia as the cause of cardiac arrest and intensive care unit (ICU) admission after ROSC were associated with higher survival rates (hazard ratio 0.056, 95% CI: 0.004 to 0.759, p < 0.05, and hazard ratio 0.072, 95% CI: 0.017 to 0.264, p < 0.0001, respectively).ConclusionsThe factors associated with ROSC rate and those associated with the survival rate after ROSC were different. Although initial shockable rhythms on AED were not associated with the survival rate, dysrhythmia as the etiology of cardiac arrest, and ICU admission were significantly associated with higher survival rates after ROSC.Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

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