ITU outcome of postcardiac arrest patients

Objectives

To assess the number of patients admitted to intensive care (ITU) post cardiac arrest (CA), their length of stay, their outcome in ITU and their hospital outcome.

Setting

A retrospective audit in a district general hospital over a 6-month period (from 1 August 2002 to 31 January 2003). Data were obtained from the ITU Acu-base, the Resuscitation Officer Data-Base and patients' medical records.

Measurements and results

Two hundred and fifty-three cardiac arrest calls were made. One hundred and ninety-eight cardiac arrests were identified and cardiopulmonary resuscitation (CPR) was performed. CPR was successful in 51 of the 198 patients (25.8%). A total of 52.9% (26 patients) were admitted to the ITU, with an average waiting time of 4.8 hours. A DNAR order was ruled out in 11 cases (21.5%) and the remaining 15 patients were transferred to the medical ward, the coronary care unit or the high-dependency unit. The length of CA was less than 10 min in 17 of the 26 patients admitted to the ITU. The mortality rate for these patients was 41.2% (seven patients). None of the nine patients (average age 74 years) whose length of CA exceed 10 min survived. Their length of stay in ITU ranged from 2 hours to 5 days. ITU outcome was 61.5% (16 patients) and hospital outcome was 19.2% (five patients).

Conclusions

Factors associated with a poor prognosis include patients older than 70 years old who have suffered prolonged cardiac arrest. Guidelines may help to select patients who would benefit most from admission to the ITU.

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