TY - JOUR
T1 - Outcomes of in-hospital cardiac arrest managed with and without a specialized code team
T2 - A retrospective observational study
AU - Fraiha, Yasmeen Abu
AU - Shafat, Tali
AU - Codish, Shlomi
AU - Frenkel, Amit
AU - Dolfin, Dror
AU - Dreiher, Jacob
AU - Konstantino, Yuval
AU - Abed, Said Abu
AU - Schwartz, Doron
AU - Fichman, Alexander
AU - Kvich, Luba
AU - Galante, Ori
N1 - Publisher Copyright:
© 2024 Abu Fraiha et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2024/9/1
Y1 - 2024/9/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85204429926&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0309376
DO - 10.1371/journal.pone.0309376
M3 - Article
C2 - 39302946
AN - SCOPUS:85204429926
SN - 1932-6203
VL - 19
JO - PLoS ONE
JF - PLoS ONE
IS - 9 September
M1 - e0309376
ER -