Characteristics and outcome among patients suffering in-hospital cardiac arrest in monitored and non-monitored areas

Aim: To describe the characteristics and outcome among patients suffering i n-hospital cardiac arrest in relation to whether the arrest took place in a ward with monitoring facilities. Methods: All patients who suffered an in- hospital cardiac arrest during a 4-year period in Sahlgrenska Hospital, Got eborg, Sweden and in whom resuscitative efforts were attempted, were prospe ctively recorded and described in terms of characteristics and outcome. Res ults: Among 557 patients, 292 (53%) had a cardiac arrest in wards with moni toring facilities. Those in a monitored location more frequently had a conf irmed or possible acute myocardial infarction (AMI) as judged to be the cau se of arrest (P < 0.0001), and the arrest was witnessed more frequently (96 vs. 79%; P < 0.0001). Ventricular fibrillation:tachycardia was observed mo re often as initial arrhythmia in monitored wards (56 vs. 44%; P = 0.006). The median interval between collapse and first defibrillation was 1 min in monitored wards and 5 min in non-monitored wards (P < 0.0001). Among patien ts with arrest in monitored wards 43.2% were discharged alive compared with 31.1% of patients in non-monitored wards (P = 0.004). Cerebral performance category (CPC-score) at discharge was somewhat better among survivors in m onitored wards. Conclusion: In a Swedish University Hospital 47% of in-hosp ital cardiac arrests in which resuscitation was attempted took place in war ds without monitoring facilities. These patients differed markedly from tho se having arrest in wards with monitoring facilities in terms of characteri stics, interval to defibrillation and outcome. A shortening of the interval between collapse and defibrillation in these patients might increase survi val even further. (C) 2001 Elsevier Science Ireland Ltd. All rights reserve d.