Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit

Resuscitation. 2014 Aug;85(8):987-92. doi: 10.1016/j.resuscitation.2014.04.002. Epub 2014 Apr 15.

Abstract

Objective: To report the incidence, characteristics and outcome of adult in-hospital cardiac arrest in the United Kingdom (UK) National Cardiac Arrest Audit database.

Methods: A prospectively defined analysis of the UK National Cardiac Arrest Audit (NCAA) database. 144 acute hospitals contributed data relating to 22,628 patients aged 16 years or over receiving chest compressions and/or defibrillation and attended by a hospital-based resuscitation team in response to a 2222 call. The main outcome measures were incidence of adult in-hospital cardiac arrest and survival to hospital discharge.

Results: The overall incidence of adult in-hospital cardiac arrest was 1.6 per 1000 hospital admissions with a median across hospitals of 1.5 (interquartile range 1.2-2.2). Incidence varied seasonally, peaking in winter. Overall unadjusted survival to hospital discharge was 18.4%. The presenting rhythm was shockable (ventricular fibrillation or pulseless ventricular tachycardia) in 16.9% and non-shockable (asystole or pulseless electrical activity) in 72.3%; rates of survival to hospital discharge associated with these rhythms were 49.0% and 10.5%, respectively, but varied substantially across hospitals.

Conclusions: These first results from the NCAA database describing the current incidence and outcome of adult in-hospital cardiac arrest in UK hospitals will serve as a benchmark from which to assess the future impact of changes in service delivery, organisation and treatment for in-hospital cardiac arrest.

Keywords: Cardiac arrest; Cardiopulmonary resuscitation; Epidemiology; In-hospital cardiac arrest; Outcome.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cardiopulmonary Resuscitation / methods*
  • Clinical Audit*
  • Female
  • Follow-Up Studies
  • Heart Arrest / epidemiology
  • Heart Arrest / therapy*
  • Hospital Mortality / trends
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prospective Studies
  • Registries*
  • Survival Rate / trends
  • Treatment Outcome
  • United Kingdom / epidemiology
  • Young Adult