Cardiac arrest patients admitted to intensive care unit after cardiopulmonary resuscitation: a retrospective cohort study to find predictors for mortality

Background: In-hospital cardiac arrest is a common situation in hospital settings. Therefore, healthcare providers should understand the reasons that could affect the results of cardiopulmonary resuscitation. We aimed to determine the independent predictors for poor outcomes after the return of spontaneous circulation in in-hospital cardiac arrest patients, and also look for a relationship between patient's background parameters and the status at intensive care unit.Methods: We did a retrospective cohort study using cardiac arrest patients admitted to the intensive care unit after successful cardiopulmonary resuscitation between 2011-2015. Patients' data were gathered from hospital database. Estimated probabilities of survival were computed using the Kaplan-Meier method. Cox proportional hazard models were used to determine associated risk factors for mortality.Results: In total, 197 cardiac arrest patients were admitted to anesthesia intensive care unit after successful cardiopulmonary resuscitation in a 4-years period. Of 197 patients, 170 (86.3%) died in intensive care unit. Median of survival days was 4 days. Comorbidity (p = 0.01), higher duration of cardiopulmonary resuscitation (p = 0.02), lower Glasgow Coma Score (p = 0.00), abnormal lactate level (p = 0.00), and abnormal mean blood pressure (p = 0.01) were the main predictors for increased mortality in cardiac arrest patients after intensive care unit admission.Conclusion: The consequent clinical status of the patients is affected by the physiological state after return of spontaneous circulation. Comorbidity, higher duration of cardiopulmonary resuscitation, lower arrival Glasgow Coma Score, abnormal lactate level, and abnormal mean blood pressure were the main predictors for increased mortality in patients admitted to the intensive care unit after successful cardiopulmonary resuscitation.& COPY; 2021 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Automated summary

This study aimed to identify independent predictors for poor outcomes after the return of spontaneous circulation in in-hospital cardiac arrest patients, and to investigate the relationship between patient's background parameters and the status at the intensive care unit. The results showed that comorbidity, longer duration of cardiopulmonary resuscitation, lower Glasgow Coma Score, abnormal lactate level, and abnormal mean blood pressure were the main predictors for increased mortality in patients admitted to the intensive care unit after successful cardiopulmonary resuscitation.