Cardiac arrest after pulmonary aspiration in hospitalised patients: a national observational study.

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Cardiac arrest after pulmonary aspiration in hospitalised patients : a national observational study.

Albert, Malin (author): Karolinska Institutet

Herlitz, Johan, 1949- (author): Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,PreHospen

Rawshani, Araz, 1986 (author): Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine

Ringh, Mattias (author): Karolinska Institutet

Claesson, Andreas (author): Karolinska Institutet

Djärv, Therese (author): Karolinska Institutet

Nordberg, Per (author): Karolinska Institutet

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(creator_code:org_t)

2020-03-19
2020
English.
In: BMJ Open. - : BMJ. - 2044-6055. ; 10:3

Related links:: https://doi.org/10.1...; show more...; https://hb.diva-port... (primary) (Raw object); https://bmjopen.bmj....; https://urn.kb.se/re...; https://doi.org/10.1...; http://kipublication...; https://gup.ub.gu.se...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

OBJECTIVE: To study characteristics and outcomes among patients with in-hospital cardiac arrest (IHCA) due to pulmonary aspiration.DESIGN: A retrospective observational study based on data from the Swedish Registry of Cardiopulmonary Resuscitation (SRCR).SETTING: The SRCR is a nationwide quality registry that covers 96% of all Swedish hospitals. Participating hospitals vary in size from secondary hospitals to university hospitals.PARTICIPANTS: The study included patients registered in the SRCR in the period 2008 to 2017. We compared patients with IHCA caused by pulmonary aspiration (n=127), to those with IHCA caused by respiratory failure of other causes (n=2197).PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome was 30-day survival. Secondary outcome was sustained return of spontaneous circulation (ROSC) defined as ROSC at the scene and admitted alive to the intensive care unit.RESULTS: In the aspiration group 80% of IHCA occurred on general wards, as compared with 63.6% in the respiratory failure group (p<0.001). Patients in the aspiration group were less likely to be monitored at the time of the arrest (18.5% vs 38%, p<0.001) and had a significantly lower rate of sustained ROSC (36.5% vs 51.6%, p=0.001). The unadjusted 30-day survival rate compared with the respiratory failure group was 7.9% versus 18.0%, p=0.024. In a propensity score analysis (including variables; year, age, gender, location of arrest, initial heart rhythm, ECG monitoring, witnessed collapse and a previous medical history of; cancer, myocardial infarction or heart failure) the OR for 30-day survival was 0.46 (95% CI 0.19 to 0.94).CONCLUSIONS: In-hospital cardiac arrest preceded by pulmonary aspiration occurred more often on general wards among unmonitored patients. These patients had a lower 30-day survival rate compared with IHCA caused by respiratory failure of other causes.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

accident & emergency medicine
adult cardiology
adult intensive & critical care
cardiology
intensive & critical care
Människan i vården
The Human Perspective in Care
accident & emergency medicine
adult cardiology
adult intensive & critical care
cardiology
intensive & critical care

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ref (subject category)
art (subject category)

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By the author/editor: Albert, Malin; Herlitz, Johan, ...; Rawshani, Araz, ...; Ringh, Mattias; Claesson, Andrea ...; Djärv, Therese; show more...; Nordberg, Per; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

Articles in the publication: BMJ Open

By the university: University of Borås; Karolinska Institutet; University of Gothenburg

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