Skip to main content
Top
Published in: Intensive Care Medicine 12/2014

01-12-2014 | Original

Temporal trends in cardiac arrest incidence and outcome in Finnish intensive care units from 2003 to 2013

Authors: I. Efendijev, R. Raj, M. Reinikainen, S. Hoppu, M. B. Skrifvars

Published in: Intensive Care Medicine | Issue 12/2014

Login to get access

Abstract

Purpose

To estimate temporal trends in incidence and hospital mortality after cardiac arrest in Finnish intensive care units.

Methods

Using a large nationwide intensive care unit (ICU) database we identified patients suffering from cardiac arrest following ICU admission (ICU-CA) during the study period (2003–2013). ICU-CA was defined as need for cardiopulmonary resuscitation and/or defibrillation (non-arrest cardioversions were excluded) according to the Therapeutic Intervention Scoring System-76. Patients admitted with an admission diagnosis of cardiac arrest were excluded. We determined crude incidence and risk-adjusted hospital mortality (based on a customized severity of illness model) for all ICU-CA patients, and for predefined admission diagnosis subgroups. Temporal trends for the observed period were calculated for crude incidence and risk-adjusted hospital mortality.

Results

Crude incidence for all ICU-CA patients was 29/1,000 ICU admissions, with the highest incidence 118/1,000 in the non-operative cardiovascular subgroup. Overall hospital mortality for ICU-CA patients was 55.5 % [95 % confidence interval (CI) 54–57 %]. Hospital mortality was 53.1 % (95 % CI 50.4–55.8 %) for non-operative cardiovascular ICU-CA patients, 32.9 % (95 % CI 26.9–38.9 %) for post cardiac surgery ICU-CA patients, and 56.3 % (95 % CI 51.2–61.3 %) for neurological/neurosurgical ICU-CA patients. There was a significant reduction in the overall ICU-CA incidence and in the risk-adjusted hospital mortality of ICU-CA and non-cardiac arrest cases (non-CA) over the observed study period (p < 0.001).

Conclusion

Our data suggest that the incidence of ICU-CA has decreased in Finnish ICUs between 2003 and 2013. Similar reduction in hospital mortality over time was observed for both ICU-CA and non-CA populations.
Appendix
Available only for authorised users
Literature
3.
go back to reference Peberdy MA, Kaye W, Ornato JP et al (2003) Cardiopulmonary resuscitation of adults in the hospital: a report of 14720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation 58:297–308. doi:10.1016/S0300-9572(03)00215-6 PubMedCrossRef Peberdy MA, Kaye W, Ornato JP et al (2003) Cardiopulmonary resuscitation of adults in the hospital: a report of 14720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation 58:297–308. doi:10.​1016/​S0300-9572(03)00215-6 PubMedCrossRef
6.
go back to reference Smith DL, Kim K, Cairns BA et al (1995) Prospective analysis of outcome after cardiopulmonary resuscitation in critically ill surgical patients. J Am Coll Surg 180:394–401PubMed Smith DL, Kim K, Cairns BA et al (1995) Prospective analysis of outcome after cardiopulmonary resuscitation in critically ill surgical patients. J Am Coll Surg 180:394–401PubMed
7.
go back to reference Anthi A, Tzelepis GE, Alivizatos P et al (1998) Unexpected cardiac arrest after cardiac surgery: incidence, predisposing causes, and outcome of open chest cardiopulmonary resuscitation. Chest 113:15–19PubMedCrossRef Anthi A, Tzelepis GE, Alivizatos P et al (1998) Unexpected cardiac arrest after cardiac surgery: incidence, predisposing causes, and outcome of open chest cardiopulmonary resuscitation. Chest 113:15–19PubMedCrossRef
8.
go back to reference Wallace S, Ewer MS, Price KJ, Feeley TW (2002) Outcome and cost implications of cardiopulmonary resuscitation in the medical intensive care unit of a comprehensive cancer center. Support Care Cancer 10:425–429. doi:10.1007/s00520-002-0353-4 PubMedCrossRef Wallace S, Ewer MS, Price KJ, Feeley TW (2002) Outcome and cost implications of cardiopulmonary resuscitation in the medical intensive care unit of a comprehensive cancer center. Support Care Cancer 10:425–429. doi:10.​1007/​s00520-002-0353-4 PubMedCrossRef
10.
go back to reference Skrifvars MB, Varghese B, Parr MJ (2012) Survival and outcome prediction using the Apache III and the out-of-hospital cardiac arrest (OHCA) score in patients treated in the intensive care unit (ICU) following out-of-hospital, in-hospital or ICU cardiac arrest. Resuscitation 83:728–733. doi:10.1016/j.resuscitation.2011.11.036 PubMedCrossRef Skrifvars MB, Varghese B, Parr MJ (2012) Survival and outcome prediction using the Apache III and the out-of-hospital cardiac arrest (OHCA) score in patients treated in the intensive care unit (ICU) following out-of-hospital, in-hospital or ICU cardiac arrest. Resuscitation 83:728–733. doi:10.​1016/​j.​resuscitation.​2011.​11.​036 PubMedCrossRef
15.
go back to reference Karetzky M, Zubair M, Parikh J (1995) Cardiopulmonary resuscitation in intensive care unit and non-intensive care unit patients. Immediate and long-term survival. Arch Intern Med 155:1277–1280PubMedCrossRef Karetzky M, Zubair M, Parikh J (1995) Cardiopulmonary resuscitation in intensive care unit and non-intensive care unit patients. Immediate and long-term survival. Arch Intern Med 155:1277–1280PubMedCrossRef
17.
go back to reference Landry FJ, Parker JM, Phillips YY (1992) Outcome of cardiopulmonary resuscitation in the intensive care setting. Arch Intern Med 152:2305–2308PubMedCrossRef Landry FJ, Parker JM, Phillips YY (1992) Outcome of cardiopulmonary resuscitation in the intensive care setting. Arch Intern Med 152:2305–2308PubMedCrossRef
19.
go back to reference Peterson MW, Geist LJ, Schwartz DA et al (1991) Outcome after cardiopulmonary resuscitation in a medical intensive care unit. Chest 100:168–174PubMedCrossRef Peterson MW, Geist LJ, Schwartz DA et al (1991) Outcome after cardiopulmonary resuscitation in a medical intensive care unit. Chest 100:168–174PubMedCrossRef
22.
go back to reference Tortolani AJ, Risucci DA, Rosati RJ, Dixon R (1990) In-hospital cardiopulmonary resuscitation: patient, arrest and resuscitation factors associated with survival. Resuscitation 20:115–128PubMedCrossRef Tortolani AJ, Risucci DA, Rosati RJ, Dixon R (1990) In-hospital cardiopulmonary resuscitation: patient, arrest and resuscitation factors associated with survival. Resuscitation 20:115–128PubMedCrossRef
25.
go back to reference Rea TD, Pearce RM, Raghunathan TE et al (2004) Incidence of out-of-hospital cardiac arrest. Am J Cardiol 93:1455–1460PubMedCrossRef Rea TD, Pearce RM, Raghunathan TE et al (2004) Incidence of out-of-hospital cardiac arrest. Am J Cardiol 93:1455–1460PubMedCrossRef
26.
go back to reference Pell JP, Corstorphine M, McConnachie A et al (2006) Post-discharge survival following pre-hospital cardiopulmonary arrest due to cardiac aetiology: temporal trends and impact of changes in clinical management. Eur Heart J 27:406–412. doi:10.1093/eurheartj/ehi604 PubMedCrossRef Pell JP, Corstorphine M, McConnachie A et al (2006) Post-discharge survival following pre-hospital cardiopulmonary arrest due to cardiac aetiology: temporal trends and impact of changes in clinical management. Eur Heart J 27:406–412. doi:10.​1093/​eurheartj/​ehi604 PubMedCrossRef
27.
31.
go back to reference Keene AR, Cullen DJ (1983) Therapeutic intervention scoring system: update 1983. Crit Care Med 11:1–3PubMedCrossRef Keene AR, Cullen DJ (1983) Therapeutic intervention scoring system: update 1983. Crit Care Med 11:1–3PubMedCrossRef
32.
go back to reference Legall JR, Lemeshow S, Saulnier F (1993) A new simplified acute physiology score (SAPS-II) based on a European/North American multicenter study. JAMA 270:2957–2963CrossRef Legall JR, Lemeshow S, Saulnier F (1993) A new simplified acute physiology score (SAPS-II) based on a European/North American multicenter study. JAMA 270:2957–2963CrossRef
34.
36.
37.
go back to reference Sandroni C, Nolan J, Cavallaro F, Antonelli M (2007) In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intensive Care Med 33:237–245PubMedCrossRef Sandroni C, Nolan J, Cavallaro F, Antonelli M (2007) In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intensive Care Med 33:237–245PubMedCrossRef
38.
go back to reference Al-Alwan A, Ehlenbach WJ, Menon PR et al (2014) Cardiopulmonary resuscitation among mechanically ventilated patients. Intensive Care Med 40:556–563PubMedCrossRef Al-Alwan A, Ehlenbach WJ, Menon PR et al (2014) Cardiopulmonary resuscitation among mechanically ventilated patients. Intensive Care Med 40:556–563PubMedCrossRef
39.
go back to reference Nolan JP, Soar J, Zideman DA et al (2010) European Resuscitation Council guidelines for resuscitation 2010 section 1. Executive summary. Resuscitation 81:1219–1276PubMedCrossRef Nolan JP, Soar J, Zideman DA et al (2010) European Resuscitation Council guidelines for resuscitation 2010 section 1. Executive summary. Resuscitation 81:1219–1276PubMedCrossRef
41.
go back to reference Cummins RO, Chamberlain D, Hazinski MF et al (1997) Recommended guidelines for reviewing, reporting, and conducting research on in-hospital resuscitation: the in-hospital “Utstein style”. A statement for healthcare professionals from the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, the Australian Resuscitation Council, and the Resuscitation Councils of Southern Africa. Resuscitation 34:151–183PubMedCrossRef Cummins RO, Chamberlain D, Hazinski MF et al (1997) Recommended guidelines for reviewing, reporting, and conducting research on in-hospital resuscitation: the in-hospital “Utstein style”. A statement for healthcare professionals from the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, the Australian Resuscitation Council, and the Resuscitation Councils of Southern Africa. Resuscitation 34:151–183PubMedCrossRef
Metadata
Title
Temporal trends in cardiac arrest incidence and outcome in Finnish intensive care units from 2003 to 2013
Authors
I. Efendijev
R. Raj
M. Reinikainen
S. Hoppu
M. B. Skrifvars
Publication date
01-12-2014
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 12/2014
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-014-3509-z

Other articles of this Issue 12/2014

Intensive Care Medicine 12/2014 Go to the issue