Clinical outcome in patients who experienced inhospital cardiac arrest by underlying disease

Introduction

Some clinical diagnoses such as sepsis, renal failure, metastatic cancer, house-bound lifestyle, and stroke are associated with worse prognosis after inhospital cardiac arrest (IHCA) [1–3]. But there are a few reports about chronic liver disease, Asian people, and the incidence of IHCA is rarely reported in the literature. The aim of this study was to evaluate the hospital mortality of adult patients who had experienced IHCA by underlying disease and the incidence of IHCA.

Methods

Between March and October 2008, 69 patients who experienced IHCA were prospectively enrolled in the study. There were 64,345 total admissions to the hospital in this period. Patients who had cardiac arrests in the ICU, emergency room, and operating room were excluded from this study. The hospital mortality compared group A (chronic liver disease, 10 patients and cancer, 24 patients) with group B (chronic lung disease and heart failure, chronic renal disease and diabetes mellitus).

Results

The incidence of IHCA was 1.07 events per 1,000 hospital admissions. Of the 69 enrolled patients, 34 were assigned to group A and 35 to group B. The mean patient age of group B was higher than group A (66.7 vs. 56.5 years, P = 0.003). There was no difference of return of spontaneous circulation (ROSC) more than 20 minutes between the two groups (group A, 53% vs. group B, 63%, P = 0.40). The hospital mortalities of underlying disease were presented: chronic liver disease (90%), cancer (88%), chronic lung disease (20%), and heart failure (54%). The hospital mortality was higher in group A than in group B (88.2% vs. 45.7%, P < 0.001). The hospital mortality was higher during the night compared with during the day (80% vs. 50%, P = 0.01) and ROSC was higher during the day than during the night (80% vs. 41%, P = 0.001).

Conclusion

In this study, the chronic liver disease and cancer group had poor prognosis compared with the other underlying diseases such as chronic lung disease or heart failure.