Incidence, outcome and trends of in-hospital cardiac arrest over a ten-year period in a Swiss tertiary hospital

Abstract

Background: Although in-hospital cardiac arrest (IHCA) occurs frequently, it is less well described in the literature and data is rare compared to out-of-hospital cardiac arrest (OHCA), especially with regard to incidence and outcomes.

Objective: The aim of this retrospective study was to analyze the incidence, characteristics, outcomes and potential predictors of outcome of IHCA occurring from 2012 to 2022 at a tertiary hospital in Switzerland.

Methods: All in-hospital cardiac arrest missions over a ten-year period were retrospectively analyzed. Subsequently, statistical analysis was conducted to identify variables influencing the outcome (outcomes of interest were return of spontaneous circulation (ROSC) and survival after 6 and 12 months).

Results: Over a ten-year period, there were 364 resuscitations, resulting in an overall incidence of 1.87 resuscitation per 1000 hospitalizations. ROSC was achieved in 63.4 % and 37.4 % were alive at 12 months. In 71.2 % the initial rhythm was non-shockable. Observed cardiac arrest and continuous ECG monitoring were significant positive predictors for ROSC and improved survival. Older age was associated with worse survival throughout the study period. Over the ten-year study period both incidence and outcomes of IHCA were unchanged.

Conclusion: HCA was infrequent but associated with high mortality rates. Continuous ECG monitoring emerged as a robust predictor for achieving ROSC and for improved survival following IHCA.

Keywords: Cardiopulmonary resuscitation; In-hospital cardiac arrest.