Clinical paperIncidence and outcome of adult in-hospital cardiac arrest in Beijing, China☆
Introduction
Despite the development of resuscitation protocols and increasing knowledge about cardiopulmonary resuscitation (CPR), in-hospital cardiac arrest (IHCA) is associated with significant morbidity and mortality.1, 2, 3, 4, 5
In 1997, the Utstein style guidelines for the documentation and reporting of IHCA were published, which allowed for the reviewing, reporting, and conducting of research on in-hospital resuscitation across medical centres.6 Subsequent updating of the guideline's core variables have made this process more simplified and practical.7 Many studies on IHCA have been published during the past two decades, and their results have contributed extensively to the development of modern CPR science.8, 9
There are no previous reports regarding the incidence and outcome following IHCA in Beijing, China. In this study, we used the Utstein style guidelines to prospectively collect and analyse data on in-hospital resuscitations in Beijing during 2014. Using a systematic evaluation, we also attempted to determine which factors were associated with improved outcome following IHCA.
Section snippets
Study design
This was a prospective, observational multicentre study of IHCAs conducted between January 1 and December 31, 2014 in Beijing, China. Eligible cases were 14 years or older, and all surviving patients were followed out to 1 month.
Setting
We collected data on total admissions and total IHCAs from 12 Level III or Level II hospitals in Beijing over a 1-year period. The characteristics of the hospitals are shown in Table 1. These hospitals are located in eight districts in Beijing, including six urban and
Study population
We identified 10,198 patients who experienced an IHCA at one of the 12 hospitals during the 1-year study period. Within this patient population, CPR was not attempted in 7486 cases. A total of 2712 patients were resuscitated and documented using the Utstein template (Fig. 1). Characteristics of these CPR recipients are shown in Table 2. Of these patients, over half (57.9%) were over 60 years old, and one-third (873) were women.
Incidence
The 12 hospitals had a total of 582,242 admissions combined during
Discussion
This is the first study of IHCA in Beijing using the Utstein style. We calculated the incidence of IHCA in Beijing according to data obtained from 12 hospitals in a 1-year span. Our evaluation shows that the incidence of IHCA is 17.5 per 1000 admissions in Beijing. For individual hospitals, the median incidence of 19.9 per 1000 hospital admissions was higher than that reported in the United States (4.02), the United Kingdom (1.6), and most European countries.3, 4, 5, 10, 11 We found that all
Conclusions
The incidence of IHCA in Beijing is higher than that reported in the United States and in European countries, and the overall rate of ROSC and survival to discharge of IHCA patients in Beijing is also lower. Factors associated with survival to hospital discharge were female sex, age <60 years, and VF/VT as the initial rhythm. Medical facilities should consider formal resuscitation team implementation to improve the outcome of IHCA going forward.
Conflict of interest statement
All the authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. All authors declare that they have no conflicts of interest.
Acknowledgments
We thank all the colleagues who collected medical information of the patients included in this study. The study was supported by a grant from the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support, code: XMLX201313.
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A Spanish translated version of the abstract of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2016.02.002.