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

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Albert, MalinKarolinska Institutet (author)

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

Article/chapterEnglish2020

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2020-03-19
BMJ,2020
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:hb-24346
https://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-24346URI
https://doi.org/10.1136/bmjopen-2019-032264DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:143546574URI
https://gup.ub.gu.se/publication/294415URI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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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 and genre

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

Added entries (persons, corporate bodies, meetings, titles ...)

Herlitz, Johan,1949-Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,PreHospen(Swepub:hb)JHZ (author)
Rawshani, Araz,1986Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xrawar (author)
Ringh, MattiasKarolinska Institutet (author)
Claesson, AndreasKarolinska Institutet (author)
Djärv, ThereseKarolinska Institutet (author)
Nordberg, PerKarolinska Institutet (author)
Karolinska InstitutetAkademin för vård, arbetsliv och välfärd (creator_code:org_t)

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In:BMJ Open: BMJ10:32044-6055

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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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