Prevalence, outcomes and factors associated with adult in hospital cardiac arrests in a low-income country tertiary hospital: a prospective observational study
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Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Emergency Medicine
Abstract
Research on cardiac arrest and cardiopulmonary resuscitation (CPR) has considerably increased in
recent decades, and international guidelines for resuscitation have been implemented and have undergone several
changes. Very little is known about the prevalence and management of in-hospital cardiac arrest in low-resource
settings. We therefore sought to determine the prevalence, outcomes and associated factors of adult inpatients
with cardiac arrest at a tertiary referral hospital in a low-income country.
Methods: Upon obtaining institutional approval, we conducted a prospective observational period prevalence
study over a 2-month period. We recruited adult inpatients with cardiac arrest in the intensive care unit and
emergency wards of Mulago Hospital, Uganda during the study period. We reviewed all files and monitoring charts,
and also any postmortem findings. Data were analyzed with Stata 12 and statistical significance was set at p < 0.05.
Results: There was a cardiac arrest in 2.3 % (190) of 8,131 hospital admissions; 34.5 % occurred in the intensive care
unit, 4.4 % in emergency operating theaters, and 3.0 % in emergency wards. A majority (63.2 %) was unwitnessed,
and only 35 patients (18.4 %) received CPR. There was return of spontaneous circulation (ROSC) in 14 (7.4 %)
cardiac arrest patients. Survival to 24 h occurred in three ROSC patients, which was only 1.6 % of all cardiac arrest
patients during the study period. Trauma was the most common primary diagnosis and HIV infection was the most
common co-morbidity.
Conclusion: Our hospital has a high prevalence of cardiac arrest, and low rates of CPR performance, ROSC, and
24-hour survival. Single provider CPR; abnormal temperatures as well as after hours/weekend CAs were associated
with lower survival rates.
Description
Keywords
cardiac arrests, adults, Hospitals
Citation
Ocen, D., Kalungi, S., Ejoku, J., Luggya, T., Wabule, A., Tumukunde, J., & Kwizera, A. (2015). Prevalence, outcomes and factors associated with adult in hospital cardiac arrests in a low-income country tertiary hospital: a prospective observational study. BMC Emergency Medicine, 15(1), 1-6.DOI 10.1186/s12873-015-0047-0