[Clinical characteristics and risk factors for mortality in perioperative cardiac arrest patients].

Objective: To summarize the clinical characteristics and explore the risk factors for in-hospital mortality in patients experiencing perioperative cardiac arrest (PCA). Methods: This study retrospectively analyzed the clinical data of patients who experienced PCA at Peking University Third Hospital from January 1, 2012, to June 30, 2022. Patients were classified into survival and non-survival groups based on their discharge outcome. Demographic characteristics, surgical information, anesthesia methods, and postoperative complications were compared between the two groups. Furthermore, a multivariable logistic regression model was employed to identify independent predictors for in-hospital mortality in PCA patients. Results: This study included a total of 225 PCA patient (152 males and 73 females), with a mean age of (60.0±17.0) years. Among them, 190 patients (84.4%) died in-hospital and 35 (15.6%) patients survived to discharge. Patients in the survivor group were significantly younger than those in the non-survivor group[(53.5±16.4) vs (61.2±16.9) years, P=0.015], and had a lower incidence of postoperative major adverse cardiovascular events (MACE) [11.4%(4/35) vs 56.8%(108/190), P<0.001], acute kidney injury [0 vs 16.0%(30/190), P=0.006], acute liver injury [0 vs 12.6%(24/190),P=0.031]. Even after adjusting for key clinical variables including age, sex, diabetes mellitus, duration of cardiopulmonary resuscitation, and the use of norepinephrine and dopamine for resuscitation, multivariable logistic regression analysis indicated that postoperative MACE remained an risk factor for in-hospital mortality in PCA patients (OR=12.18, 95%CI: 2.62-56.64, P=0.001). Conclusions: This study demonstrates a high in-hospital mortality rate among patients experiencing perioperative cardiac arrest, survivors are typically younger and experienced a lower incidence of postoperative complications. Postoperative MACE is identified as an independent predictor of in-hospital mortality in PCA patients.