Outcomes of In-hospital Cardiac Arrest Managed with and Without a Specialized Code Team: A Retrospective Observational Study

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 Sep 20

PMID 39302946

Authors

Yasmeen Abu Fraiha

Tali Shafat

Shlomi Codish

Amit Frenkel

Dror Dolfin

Jacob Dreiher

Yuval Konstantino

Said Abu Abed

Doron Schwartz

Alexander Fichman

Luba Kvich

Ori Galante

Affiliations

Soon will be listed here.

Abstract

Background: In-hospital cardiac arrest (IHCA) still has a poor prognosis despite medical advancements in recent decades. Early and high-quality cardiopulmonary resuscitation (CPR), as well as good teamwork, are important prognostic factors. There are no clear guidelines regarding the composition of a dedicated hospital CPR team. We compared outcomes of IHCA treated by a dedicated hospital CPR team compared to ward medical staff with advanced cardiac life support (ACLS) training.

Methods: A single-center retrospective observational study based on the cardiopulmonary resuscitation database of Soroka University Medical Center from January 2016 until December 2019. We compared the results of resuscitations conducted by regular ward medical staff, certified in ACLS, versus those conducted by the dedicated hospital's CPR team.

Results: Of the 360 CPR events analyzed, 141 (39.1%) ended in return of spontaneous circulation, 70 (19.4%) patients were alive after 24 hours, 23 (6.4%) survived for 30 days, and 18 (5%) survived to discharge. Of those who survived to discharge, 11 (61.1%) had a cerebral performance category (CPC) score of 1-2, and 7 (38.9%) had a score of 3-4 (mean 2.09). Survival-to-discharge was significantly higher in the CPR-team group compared to the ward-team group (7.6% vs. 1.9%, p = 0.013). However, with propensity score analysis the difference in survival became insignificant (RR = 1.97, 95% CI: 0.40-9.63, p = 0.40).

Conclusion: We found no difference in survival between IHCA treated by a dedicated hospital CPR team compared to a standard ward team, both trained with biennial ACLS training. Nevertheless, crude survival-to-discharge was significantly higher in the CPR-team group.

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