Survival following in‐hospital cardiac arrest has remained poor, at about 14%. The goal of this study was to determine the factors related to survival, and to evaluate the role of BMI and central venous access in predicting outcomes.
This was a retrospective observational study. We reviewed all electronic medical records of adult cardiopulmonary arrest that occurred between July 2008 and April 2009 at a major referral teaching hospital in southwestern Virginia. Of the 307 patients in this period with cardiopulmonary arrest, 43 patients were excluded based on insufficient data about the arrest. Clinical outcomes of interest were factors predicting survival immediately after CPR and survival at discharge from hospital. All factors associated with survival were evaluated using odds ratios (ORs) and logistic regression analysis.
There were 264 patients in the study period, of whom 61% were male and 39% were female. Return of spontaneous circulation was achieved in 36 patients (13.6%), whereas overall survival to discharge was 10.9% (29 patients). The mean age of inpatient survivors of cardiac arrest was 60.7 ± 10.5 years and that of nonsurvivors 66.7 ± 13.6 years. The mean duration of codes was 29.5 ± 15.2 minutes. Survival was highest when the initial presenting rhythm was pulseless ventricular tachycardia or ventricular fibrillation (30.6%). No significant difference in survival was detected between patients who had a central line either prior to or during the resuscitation compared with those who did not (P = 0.20). Similarly no difference in survival was detected between patients with a BMI > 35 and those with a BMI < 35 (P = 0.396). Likelihood of survival of CPR was increased when patients had the arrest in the ICU (OR 50, Cl 11.2–250), Survival was decreased in patients who were on pressors prior to the code (OR 8.5, Cl 1–70). Age greater than 65 years was associated with decreased survival overall (OR 6.7, Cl 1.9–22.4). Also, precode hypotension defined as mean arterial pressure (MAP) < 65 mm Hg, was also associated with decreased survival to hospital discharge (OR 14, Cl 3.6–55.0).
Overall, prognosis following cardiopulmonary arrest remains poor. BMI and the presence of central venous access do not predict outcome as expected. Some clinical variables such as age > 65 years, precode hypotension, precode pressors, and arrest outside the ICU setting seem to predict unfavorable outcomes after in‐hospital cardiopulmonary arrest.
S. Lutchmedial, Carilion Clinic, employee/none; A. Levitov, Carilion Clinic, employee/none; P. Katyal, Carilion Clinic, employee/none; J. John, Carilion Clinic, employee/none; R. Herbertson, Carilion Clinic, employee/none; S. Malaisamy, Carilion Clinic, employee/none.
To cite this abstract:Lutchmedial S, Levitov A, Katyal P, John J, Herbertson R, Malaisamy S. In‐Hospital Cardiopulmonary Arrest: The Role of BMI, Central Venous Catheter, and Other Predictors of Outcome. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 88. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/inhospital-cardiopulmonary-arrest-the-role-of-bmi-central-venous-catheter-and-other-predictors-of-outcome/. Accessed September 20, 2019.