Clinical Characteristics and Factors Influencing the Outcomes of In-Hospital Cardiac Arrest Patients: A Retrospective Observational Study

Abstract

Objective: Analyze the clinical characteristics and resuscitation outcomes of patients with in-hospital cardiac arrest (IHCA) and explore the factors affecting the success rate of cardiopulmonary resuscitation in IHCA patients.

Material and methods: A retrospective observational study was conducted. Patients who received resuscitative treatment for IHCA between September 2022 and December 2023 were evaluated. Clinical data and prognostic information were collected and analyzed, including age, gender, underlying diseases, time of cardiac arrest, cause of cardiac arrest, presence of shockable rhythm, application of defibrillation, duration of CPR (>30 min), presence of endotracheal intubation, cumulative dose of adrenaline, and resuscitation outcomes (return of spontaneous circulation, survival to discharge).

Results: A total of 323 IHCA patients were included in this study. After CPR treatment, 246 had return of spontaneous circulation (ROSC), with 90 surviving to discharge. Coronary artery disease, shockable initial rhythm, presence of a shockable rhythm during resuscitation, defibrillation, and absence of emergency endotracheal intubation differed statistically between the ROSC and non-ROSC groups (univariate analysis, p < 0.001) Age was a statistically significant determinant of whether patients survived to discharge (p < 0.05). Multivariate logistic regression analysis showed that CPR duration ≥ 30 min was an independent risk factor for ROSC, while younger age, application of emergency endotracheal intubation, and lower cumulative dose of adrenaline were independent protective factors for ROSC (p < 0.05).

Conclusion: Age lower than 60 years old, application of defibrillation, and emergency endotracheal intubation are positively associated with increased likelihood of ROSC. Age is an independent risk factor negatively related to survival after discharge. Clinicians should pay close attention to these factors to improve the outcomes of cardiopulmonary resuscitation patients.