Frequency, Prognosis, and Clinical Features of Unexpected versus Expected Cardiac Arrest in the Emergency Department: A Retrospective Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Settings
- A waiting area dedicated for patients classified as stable, who do not require any monitoring or acute therapy or who are waiting for their visit, results, or discharge;
- An observation area dedicated to patients classified as stable, requiring acute therapy or a low to moderate level of monitoring. This is also an area for patients waiting for boarding to other units (20 beds);
- A shock room dedicated to patients requiring immediate intensive therapy/resuscitation (e.g., victims of polytrauma or CA) (2 beds);
- An intensive-therapy room dedicated to patients requiring intensive monitoring and therapy because of their general instability (4 beds).
- Red (1) for patients requiring immediate resuscitation;
- Orange (2) for patients in the ED;
- Yellow (3) for patients in need of urgent visits;
- Green (4) for patients in need of a visit of low urgency;
- Blue (5) for patients without urgent conditions.
2.2. Definition of Unexpected Cardiac Arrest in the Emergency Department
2.3. Selection of Participants
2.4. Outcome Measures
2.5. Analysis
2.6. Ethics Approval and Consent to Participate
3. Results
3.1. Characteristics of the Study Participants
3.2. Main Results
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Unex-CAED (n = 38) | CAED (n = 71) | p | |
---|---|---|---|
Sex (M/F) (n/n; %/%) | 20/18; 52.6%/47.4% | 35/36; 49.3%/50.7% | 0.8413 |
Age, years, (mean ± SD) | 71.5 ± 15.6 | 72.7 ± 12.4 | 0.7186 |
Comorbidities, n (%): | |||
Cardiac insufficiency | 11 (28.9%) | 15 (21.1%) | 0.4797 |
Chronic kidney disease | 9 (23.7%) | 10 (14.1%) | 0.2890 |
Neoplastic disease | 10 (26.3%) | 16 (22.5%) | 0.6465 |
Coronary disease | 6 (15.8%) | 14 (19.7%) | 0.7960 |
Dementia | 1 (2.6%) | 4 (5.6%) | 0.6561 |
Alcohol dependency | 1 (2.6%) | 7 (9.9%) | 0.2571 |
Pathologic obesity | 1 (2.6%) | 4 (5.6%) | 0.6561 |
Hypertension | 17 (44.7%) | 28 (39.4%) | 0.0001 |
Atrial fibrillation | 7 (18.4%) | 11 (15.5%) | 0.0537 |
Cardiomyopathy | 1 (2.63%) | 3 (4.2%) | 1.0000 |
COPD 1 | 2 (5.3%) | 9 (12.7%) | 0.3229 |
Chronic anaemia | 0 (0.0%) | 2 (2.8%) | 0.5416 |
Hepatic cirrhosis | 0 (0.0%) | 5 (7.0%) | 0.1606 |
Unex-CAED (n = 38) | CAED (n = 71) | p | |
---|---|---|---|
Successful ROSC, n (%) | 17 (44.7%) | 24 (33.8%) | 0.3025 |
Deaths at ED, n (%) | 21 (55.3%) | 47 (66.2%) | 0.3025 |
Death during hospitalisation, n (%) | 5 (13.2%) | 11 (15.5%) | 1 |
Dependent at exception, n (%) | 10 (26.3%) | 20 (28.2%) | 1 |
Time to resuscitation, minutes (mean ± SD) | 12.6 ± 20.2 | 14.6 ± 17.9 | 0.4084 |
First observed cardiac rhythm | |||
VF, n (%) | 4 (10.5%) | 3 (4.2%) | 0.2351 |
VT, n (%) | 1 (2.6%) | 3 (4.2%) | 1 |
PEA, n (%) | 24 (63.2%) | 28 (39.4%) | 0.0265 |
Asystole, n (%) | 7(18.4%) | 35 (49.3%) | 0.0019 |
Unknown, n (%) | 2 (5.3%) | 2 (2.8%) | 0.6096 |
Defibrillation during CPR, n (%) | 5 (13.1%) | 6 (8.4%) | 0.5103 |
Total number of deaths, n (%) | 26 (68.4%) | 58 (81.2%) | 0.1519 |
Unex-CAED (n = 38) | CAED Group (n = 71) | |
---|---|---|
Triage results (colour given) | ||
Red | 0 (0.0%) | 40 (56.3%) |
Orange | 13 (34.2%) | 29 (40.8%) |
Yellow | 15 (39.5%) | 2 (2.8%) |
Green | 7 (18.4%) | 0 (0.0%) |
Blue | 0 (0.0%) | 0 (0.0%) |
CA before triage | 3 (7.9%) | 0 (0.0%) |
Main symptoms | ||
Dyspnoea | 15 (39.5%) | 34 (47.9%) |
Disturbances of consciousness | 9 (23.7%) | 32 (45.1%) |
Weakness | 8 (21.1%) | 22 (31.1%) |
Chest pain | 7 (18.4%) | 12 (16.9%) |
Abdominal pain | 6 (15.8%) | 6 (8.5%) |
Lower limb pain | 4 (10.5%) | 0 (0.0%) |
Vomiting | 5 (13.2%) | 6 (8.5%) |
Fever | 4 (10.5%) | 3 (4.2%) |
Head injury | 3 (7.9%) | 2 (2.8%) |
Politrauma | 0 (0.0%) | 1 (1.4%) |
Seizures | 0 (0.0%) | 1 (1.4%) |
Final diagnoses | (13 cases were verified during autopsy) | (9 cases were verified during autopsy) |
Acute myocardial infarction | 7 (18.4%) | 9 (12.7%) |
Malignant neoplasms with metastases | 5 (13.2%) | 19 (26.8%) |
Septic shock | 7 (18.4%) | 10 (14.1%) |
Pulmonary embolism | 4 (10.5%) | 5 (7.0%) |
Heart failure | 4 (10.5%) | 5 (7.0%) |
Pneumonia | 3 (7.9%) | 0 (0.0%) |
Ileus | 2 (5.3%) | 0 (0.0%) |
Rupture of aortic aneurysm | 1 (2.6%) | 5 (7.0%) |
Oesophageal varices bleeding | 1 (2.6%) | 4 (5.6%) |
Cardiac tamponade | 1 (2.6%) | 0 (0.0%) |
Takotsubo cardiomyopathy | 1 (2.6%) | 0 (0.0%) |
Alcohol intoxication | 1 (2.6%) | 1 (1.4%) |
Haemopneumothorax | 1 (2.6%) | 0 (0.0%) |
Intracranial haemmorhage | 0 (0.0%) | 2 (2.8%) |
Politrauma | 0 (0.0%) | 1 (1.4%) |
Aspiration | 0 (0.0%) | 2 (2.8%) |
Chronic renal disease | 0 (0.0%) | 1 (1.4%) |
Senility | 0 (0.0%) | 7 (9.9%) |
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Szaruta-Raflesz, K.; Łopaciński, T.; Siemiński, M. Frequency, Prognosis, and Clinical Features of Unexpected versus Expected Cardiac Arrest in the Emergency Department: A Retrospective Analysis. J. Clin. Med. 2024, 13, 2509. https://doi.org/10.3390/jcm13092509
Szaruta-Raflesz K, Łopaciński T, Siemiński M. Frequency, Prognosis, and Clinical Features of Unexpected versus Expected Cardiac Arrest in the Emergency Department: A Retrospective Analysis. Journal of Clinical Medicine. 2024; 13(9):2509. https://doi.org/10.3390/jcm13092509
Chicago/Turabian StyleSzaruta-Raflesz, Karolina, Tomasz Łopaciński, and Mariusz Siemiński. 2024. "Frequency, Prognosis, and Clinical Features of Unexpected versus Expected Cardiac Arrest in the Emergency Department: A Retrospective Analysis" Journal of Clinical Medicine 13, no. 9: 2509. https://doi.org/10.3390/jcm13092509
APA StyleSzaruta-Raflesz, K., Łopaciński, T., & Siemiński, M. (2024). Frequency, Prognosis, and Clinical Features of Unexpected versus Expected Cardiac Arrest in the Emergency Department: A Retrospective Analysis. Journal of Clinical Medicine, 13(9), 2509. https://doi.org/10.3390/jcm13092509