Long term survival in patients who sustained in-hospital cardiac arrest

Introduction: Cardiopulmonary resuscitation can be termed successful only if the victim survives to hospital discharge and returns to a reasonable quality of life. Aim: The aim of this study was to determine long term survival and quality of life of patients who sustained in-hospital cardiac arrest. Patients and Methods: This was a prospective interventional study of 1955 patients who sustained in- hospital cardiac arrest at a tertiary hospital in India. Adult patients who sustained cardiac arrest in the hospital were included in the study and patients who were < 18 years of age, cardiac arrest in operation theatre and patients who were brought in ‘near death’ state to the hospital were excluded. Parameters were collected during two periods, before and after introduction of Modified Early Warning Score (MEWS). Results: In the PreMEWS period, 228 out of 1135 (20%) patients had return of spontaneous circulation (ROSC), of whom 59 survived to discharge (5.19%), 51 patients (4.49%) were alive at 6 months and 45 patients (3.96%) were independent at activities of daily living (ADL). In the PostMEWS period, 202 out of 820 patients (24.6%) had ROSC, of whom 138 patients (16.82%) survived to discharge, 110 were alive at 6 months (13.41%) and 99 (12.07%) were independent at ADL. Conclusion: The rate of return of spontaneous circulation, survival to discharge rate, 6 month survival and independence at activities of daily living are all better with the use of modified early warning score.