Background

Characteristics and outcomes of patients with in-hospital cardiac arrest (IHCA) in the cardiac catheterization laboratory (CCL) have not been well-described. Thus, we compared the outcomes of patients with an IHCA in the CCL versus those in the intensive care unit (ICU) and operating rooms (OR).

Methods

Within the American Heart Association’s Get With the Guidelines®-Resuscitation registry, we identified patients ≥18 years old with IHCA in the CCL, ICU, or OR between 2000-2019. Using hierarchical multivariable logistic regression, we compared rates of survival to discharge for patients with IHCA in the CCL versus ICU and OR.

Results

Across 428 hospitals, 193,950 patients had IHCA, of whom 6865, 181,905 and 5180 were in the CCL, ICU and OR, respectively. Overall, 2614 (38.1%) patients with IHCA in the CCL survived to discharge, whereas 30,830 (16.9%) and 2096 (40.5%) survived to discharge from the ICU and OR, respectively. After adjustment, patients with IHCA in CCL were more likely to survive to discharge as compared to those with IHCA in the ICU (odds ratio, 1.37 [95%CI: 1.29-1.46], p<0.001). In contrast, those who had IHCA in the CCL were less likely to survive to discharge as compared to patients with IHCA in the OR (odds ratio, 0.81 [95%CI: 0.69-0.94], p=0.006).

Conclusion

IHCA in the CCL is not uncommon and has a lower survival rate when compared with IHCA in the OR. The reasons for this difference deserve further study given that cardiac arrest in both settings is witnessed and response time should be similar.

中文翻译：

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心导管实验室中心脏骤停的患者特征和生存结果：来自 Get with TheGuidelines® 的见解 - 复苏登记处

背景

心导管实验室 (CCL) 院内心脏骤停 (IHCA) 患者的特征和结果尚未得到充分描述。因此，我们比较了 CCL 中接受 IHCA 的患者与重症监护病房 (ICU) 和手术室 (OR) 中患者的结果。

方法

在美国心脏协会的 Get With theGuidelines®-Resusitation 登记中，我们在 2000 年至 2019 年间在 CCL、ICU 或 OR 中发现了 18 岁以上患有 IHCA 的患者。使用分层多变量逻辑回归，我们比较了 CCL 与 ICU 和 OR 中 IHCA 患者的出院生存率。

结果

在 428 家医院中，有 193,950 名患者接受了 IHCA，其中 CCL、ICU 和 OR 分别有 6865 名、181,905 名和 5180 名患者。总体而言，CCL 中有 2614 名 (38.1%) 的 IHCA 患者存活至出院，而 ICU 和 OR 中分别有 30,830 名 (16.9%) 和 2096 名 (40.5%) 存活至出院。调整后，与 ICU 中 IHCA 患者相比，CCL 中 IHCA 患者更有可能存活出院（比值比，1.37 [95%CI：1.29-1.46]，p<0.001）。相反，与 OR 中发生 IHCA 的患者相比，CCL 中发生 IHCA 的患者存活出院的可能性较小（比值比，0.81 [95%CI：0.69-0.94]，p=0.006）。

结论

CCL 中的 IHCA 并不罕见，并且与 OR 中的 IHCA 相比，其存活率较低。鉴于在两种情况下都目睹了心脏骤停并且响应时间应该相似，因此这种差异的原因值得进一步研究。