Mode of death after admission to an intensive care unit following cardiac arrest

Intensive Care Med. 2004 Nov;30(11):2126-8. doi: 10.1007/s00134-004-2425-z. Epub 2004 Sep 9.


Objective: To determine the mode of death in patients admitted to an intensive care unit (ICU) after cardiac arrest who died before hospital discharge.

Design: Prospectively defined retrospective review of a database and individual patient medical records and ICU charts.

Setting: Eleven-bed multidisciplinary intensive care unit in a general hospital in the United Kingdom.

Patients and participants: All patients admitted to ICU between February 1998 and July 2003 after a cardiac arrest in the previous 24 h.

Measurements and results: The outcome at hospital discharge and mode of death in non-survivors were recorded. Based on the mode of death, non-survivors were placed in one of three groups: multiple organ failure death, neurological death or cardiovascular death. Two hundred and five patients were admitted to ICU after a cardiac arrest; 113 (55.1%) after out-of-hospital cardiac arrest and 92 (44.9%) after in-hospital cardiac arrest. One hundred and twenty-six (61.5%) patients died before hospital discharge and of these 58 (46.0%) died due to neurological injury. After cardiac arrest, 22.9% of the in-hospital patients and 67.7% of the out-of-hospital patients died due to neurological injury, irrespective of the primary cardiac arrest arrhythmia.

Conclusions: Two-thirds of the patients dying after out-of-hospital cardiac arrest died due to neurological injury and this proportion was approximately the same for ventricular fibrillation/ventricular tachycardia and pulseless electrical activity/asystole. Approximately a quarter of the patients dying after in-hospital cardiac arrest died due to neurological injury.

MeSH terms

  • Brain Injuries / etiology*
  • Brain Injuries / mortality*
  • Cardiopulmonary Resuscitation
  • Cause of Death*
  • Heart Arrest / complications
  • Heart Arrest / mortality*
  • Heart Arrest / therapy
  • Hospital Mortality*
  • Humans
  • Intensive Care Units* / statistics & numerical data
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / mortality
  • Prospective Studies
  • Retrospective Studies
  • Statistics, Nonparametric
  • United Kingdom / epidemiology