Background: Despite continued efforts to further improve resuscitation strategies, the survival rate of patients who had in-hospital cardiac arrest (IHCA) remains to be low. This study aims to determine the factors associated with mortality among IHCA cases.
Methodology: A retrospective cohort study was done at the Philippine Heart Center (PHC) from August 1, 2017 to December 31, 2017. The clinical characteristics, location, time, duration and causes of arrest were described. Predictors of mortality were then analyzed. Purposive sampling was employed.
Results: There were a total of 105 patients included in this study. The mean age was 58.55 + 17.4 years with male predominance (62%). Septic shock (37.1%) and cardiogenic shock (35.2%) were the leading immediate causes of cardiac arrest. The most common antecedent cause of death was pneumonia (45%) followed by myocardial infarction (18%). There were significantly more patients presenting with asystole who expired than were discharged improved (44.8% vs 5.6%, p 0.002). Conversely, there were more patients with a shockable rhythm of either ventricular tachycardia (33.3% vs 11.5%, p 0.027) or ventricular fibrillation (38.9% vs 9.2%, p 0.003) at the time of cardiac arrest who were discharged improved after return of spontaneous circulation. On multivariate analysis, predictors of survival include patients who underwent coronary artery bypass grafting (Adjusted OR 0.03, CI 0.01-0.17, p <0.001) and those with a shockable rhythm (Adjusted OR 16.2, CI 3.3-80.2, p 0.001). In our cohort, eighty-three percent of the patients expired. The survival to discharge rate was 13%.
Conclusion: Our study revealed a lower survival-to-discharge rate compared to the middle and high income countries. Early recognition and prompt response to patients with early signs of deterioration at the non-intensive care units are of vital importance to improve survival.