Date of Award

11-8-2022

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr. Uzma Rahim Khan

Second Advisor

Dr Noor Baig

Third Advisor

Ahmed Rahim

Department

Community Health Sciences

Abstract

Aim: The aim of this study was to determine the survival of in-hospital cardiac arrest (IHCA) patients and to determine associated the factors associated with survival at discharge.
Methods: This was a retrospective observational cohort study of patients admitted to Aga Khan University Hospital, Karachi Pakistan from August 2021 to July 31, 2022, who had IHCA. Parametric survival analysis was used to assess the association between CPR duration and covariates with survival at discharge.
Results: Among 72 patients admitted, 39 (54%) patients achieved return of spontaneous circulation (ROSC). Survival to hospital discharge was 18% (13/72). Majority of the cardiac arrest patients were males (HR=1.23 [0.70-2.16]) and better survival was noted in females. Mortality was high in patients admitted to ICU (93%) and special care units (95%). While better survival noted in patient in general wards (25% HR= 0.24 [0.07-0.78]) and emergency department (42% HR= 0.67 [0.33-1.36]). Majority of the patients (87.5%) presented with nonshockable rhythm. While increase survival was noted in patients presented with shockable (33%). Sepsis (54% HR=0.61 [0.36-1.02]) and hypotension (57% HR=2.04 [1.21-3.44]) were found to be the most common pre-existing condition leading to cardiac arrest. Majority of cardiac arrest occurred during the day times (66.7%) while survival was worse when cardiac arrest at night times (HR=2.09 [1.24-3.55]). CPR time >10 minutes (HR=4.24 [2.24-8.02]), time of cardiac arrest (HR=2.18 [1.29-3.71]) and Respiratory insufficiency (HR=0.56) was found to be significant in determining survival at discharge.
Conclusions: Lower survival is noted as compared to global data. Survival at discharge was higher in patients who received ≤ 10 minutes of CPR. Better monitoring and staffing at night times and early recognition at night may help in improving the survival of IHCA.

First Page

1

Last Page

42

Download

Share

COinS