Each year, over 540,000 patients undergo cardiac arrest (CA) in China. Little is known about the short-term prognosis of these patients after discharge. This study aimed to describe mortality of 28 days following in-hospital cardiac arrest (IHCA), and identify independent risk factors for it.
A single institution cohort study was undertaken to investigate the 28-day mortality following IHCA. Patients, over 18 years, resuscitated to return of spontaneous circulation (ROSC) during Oct. 2010 to Dec. 2016 were included and follow-up for 28 days post CA. Cox regression analyses were conducted to identify the independent risk factors for IHCA patients’ 28-day mortality in south west of China.
Results There were 1106 IHCAs included in the present study. Among them, 951 IHCAs got ROSC and were included, including 611 (64.25%) males and 340 (35.75%) females, with their average age being 58.24±17.96 years. Among them, 67 (7.05%) survived at least 28 days post ROSC.
Univariate analysis indicated that cause of CA, initial rhythm, EICU admission, RBC, PLT, WBC, MONO, TBIL, DBIL, IBIL, ALT, AST, TP, ALB, CHOL, ALP, GGT, LDH, HBDH, PT, INR, APTT were the factors might affect the survival time for IHCA patients post ROSC.
COX regression showed that initial rhythm before CA (HR=1.245 (1.068, 1.451), P=0.005), EICU admission (HR=0.747 (0.638, 0.874), P<0.001), WBC (HR=1.005 (1.002, 1.008), P＜0.001), TBIL (HR=0.991 (0.985, 0.998), P=0.007), DBIL (HR=1.007 (1.000, 1.014), P=0.046), IBIL (HR=1.014 (1.007, 1.022), P＜0.001), ALB (HR=0.979 (0.965, 0.992), P=0.002), and ALP (HR=1.001 (1.000, 1.002) , P=0.003) were independent factors affecting the 28-day mortality of IHCA patients post ROSC.
TBIL and ALB were protective factors, while WBC, DBIL, IBIL and ALP were risk factors for 28-day mortality following IHCA. The mortality risk of patients with EICU admissions were lower compared with those of non-EICU admission IHCA patients, and the mortality risk of patients with asystole were higher than other kinds of initial rhythm.