Epidemiology and Etiology of In-Hospital Cardiac Arrest at The American
University of Beirut Medical Center (AUBMC)
Abstract
Introduction: In-hospital cardiac arrest(IHCA) constitutes a significant
cause of morbidity and mortality. we devised this study to shed some
light on it to better inform both hospitals and policymakers. Methods:
We analyzed retrospective data from 680 IHCAs at the American University
of Beirut Medical Center between July 1st, 2016, and May 2nd, 2019.
Sociodemographic variables included age, sex, and comorbidities in the
Charlson Comorbidity Index(CCI). IHCA variables were the day of the
week, time from activation to arrival, event location, initial cardiac
rhythm, the total number of IHCA events, and the months and years of the
IHCAs. We considered the return of spontaneous circulation(ROSC) and
survival to discharge(StD) to be our outcomes of interest. Results: The
incidence of IHCA was 6.58 per 1000 hospital admissions. Non-shockable
rhythms were 90.7% of IHCAs. Most IHCAs occurred in the Closed care
units(87.9%) and on weekdays(76.5%). ROSC followed 56% of the IHCAs.
Only 5.4% achieved StD. Survival outcomes were not significantly
different between the time of the day and were higher in cases with a
shockable rhythm. ROSC wasn’t significantly different between weekdays
and weekends. however, StD was higher on weekdays. A high CCI was
associated with decreased StD. Conclusion: The incidence of IHCA was
high, and its outcomes were lower compared to other developed countries.
Survival outcomes were better for patients who had a shockable rhythm
and were similar between the time of the day. These findings may help
inform hospitals and policymakers about the magnitude and quality of
IHCA care in Lebanon