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.