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Does Intubation Affect Survival Among Patients Experiencing In-Hospital Cardiopulmonary Arrest?

Yıl 2022, Cilt: 5 Sayı: 3, 103 - 108, 30.09.2022
https://doi.org/10.54996/anatolianjem.1058127

Öz

Aim: Cardiopulmonary arrest is an important public health problem that contributes substantially to in-hospital morbidity and mortality. The present study aimed to determine the factors that affect in-hospital mortality and determine whether intubation contributes to survival among patients experiencing in-hospital cardiopulmonary arrest.


Material and Methods: This retrospective, cross-sectional study was conducted by examining the event notification forms of all patients with a "Code Blue" call between January 1, 2014, and December 31, 2018. Patients who died and those who did not die after intervention were compared concerning age, sex, location and time of the call, and interventions implemented. Patients who received cardiopulmonary resuscitation alone and those who received cardiopulmonary resuscitation + intubation were compared concerning in-hospital mortality; p-values < 0.05 were considered statistically significant.


Results: In total, 924 patients were included in the present study. The most frequent calls were made from the wards in the hospital, at a rate of 64.4%. The in-hospital mortality rate was 42.4%. In-hospital mortality rates were significantly higher in the elderly, in those who were given overtime and service calls, and in
those who received cardiopulmonary resuscitation or cardiopulmonary resuscitation + intubation. Among patients who received CPR, intubation did not affect survival. Sex, age, time of call, and intervention were significant predictors of in-hospital mortality.


Conclusion: Code blue calls occurred primarily in the hospital wards outside of working hours, and improper call rates were high. Moreover, age, location and time of call, and interventions were independent risk factors for in-hospital mortality; intubation did not contribute to survival among patients experiencing in-hospital cardiopulmonary arrest.

Kaynakça

  • Mapp A, Goldsack J, Carandang L, Buehler JW, Sonnad SS. Emergency codes: a study of hospital attitudes and practices. J Healthc Prot Manage. 2015;31(2):36-47.
  • Sandroni C, Nolan J, Cavallaro F, Antonelli M. In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intensive Care Med 2007;33:337-45.
  • Rakşc D, Rumboldt Z, Carevic V, Bagatin J, Polic S, Pivac N. In-hospital cardiac arrest and resuscitation outcomes: rationale for sudden cardiac death approach. Croat Med J. 2005;46:907-12. .
  • Jacobs I, Nadkarni V, Bahr J, Berg RA, Billi JE, Bossaert L et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries. Resuscitation. 2004;63:233-249.
  • Dane FC, Russell-Lindgren KS, Parish DC, Durham MD, Brown TD. Inhospital resuscitation: association between ACLS training and survival to discharge. Resuscitation. 2000;47:83-87. .
  • Koltka N, Çelik M, Yalman A, Süren M, Öztekin F. Kardiyopulmoner resüsitasyonun başarısına etkisi olan faktörler. Türk Anest Rean Der Dergisi. 2008;36(6):366-72. .
  • Sanders AB, Berg RA, Burress M, Genova RT, Kern KB, Ewy GA. The efficacy of an ACLS training program for resuscitation from cardiac arrest in a rural community. Ann Emerg Med. 1994;23:56-59.
  • Joint Commission on Accreditation of Healthcare Organization. Sentinal event statistics. June 29, 2004. Avaliable at: www.Jcaho.org/accredited+organisations/ambulatory+care/sentinel+even ts/sentinel+events+statistics.htm
  • Price JW, Applegarth O, Vu M, Price JR. Code blue emergencies: A team task analysis and educational Initiative. Canadian Med Educ J. 2012, 3(1).
  • Perkins GD, Oasveengen TM, Maconochie, Soar J et al. European resuscitation council guidelines for resuscitation: 2017 update Resuscitation. 2017;123:43-50. .
  • Newell C, Grier S, Soar J. Airway and ventilation management during cardiopulmonary resuscitation and after succesful resuscitation. Critical Care (2018) 22:190.
  • Soar J, Nolan JP, Bottiger BW, Perkins GD, Lott C, Carli P, Pellis T, Sandroni C, Skrifvars MB, Smith GB, et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation. 2015;95:100–47.
  • Voss S, Rhys M, Coates D, Greenwood R, Nolan JP, Thomas M, Benger J. How do paramedics manage the airway during out of hospital cardiac arrest? Resuscitation. 2014;85(12):1662–6. .
  • Olasveengen TM, de Caen AR, Mancini ME et al. 2017 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations summary. Resuscitation. 2017;121:201–14.
  • Donoghue AJ, Abella BS, Merchant R, et al. Cardiopulmonary resuscitation for in-hospital events in the emergency department: A comparison of adult and pediatric outcomes and care processes. Resuscitation. 2015;92:94–100.
  • Fouche PF, Simpson PM, Bendall J, Thomas RE, Cone DC, Doi SA. Airways in out-of-hospital cardiac arrest: systematic review and metaanalysis. Prehosp Emerg Care. 2014;18(2):244–56.
  • Jabre P, Penaloza A, Pinero D et al.Effect of bag-mask ventilation vs endotracheal intubation during cardiopulmonary resuscitation on neurological outcome after out-of-hospital cardiorespiratory arrest:a randomized clinical trial. JAMA.2018;319(8):779–87.
  • Andersen LW, Granfeldt A, Callaway CW et al. American Heart Association's get with the Guidelines- Resuscitation I. Association between tracheal intubation during adult inhospital cardiac arrest and survival. JAMA. 2017;317(5):494–506.
  • Meaney PA, Bobrow BJ, Mancini ME, et al. Cardiopulmonary resuscitation quality: improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation. 2013;128:417–435.
  • Kuday Kaykısız E, Tongün A, Sönmezsoy M, Güven R. Code Blue in Theory Versus Daily Practice: Data from a Secondary Care Hospital. Eurasian J Emerg Med 2017;16(4):157-161.
  • Bayramoglu A, Cakir ZG, Akoz A, Ozogul B, Aslan Ş, Saritemur M. Patient-Staff Safety Applications: The Evaluation of Blue Code Reports. Eurasian J Med 2013; 45: 163-6.
  • Eroglu SE, Onur Ö, Urgan O, Denizbasi A, Akoglu H. Blue code: Is it a real emergency? World J Emerg Med 2014; 5: 20-3.
  • Çiçekçi F, Atıcı S.S. Mavi kod çağrılarına bağlı kardiyo-pulmoner resüsitasyon uygulamaları sonuçlarının değerlendirilmesi. Genel Tıp Derg 2013;23(3):70-6.
  • Brindley PG, Markland DM, Mayers I, et al. Predictors of survival following in-hospital adult cardiopulmonary resuscitation. CMAJ 2002;167:343-8.
  • Abella BS, Alvarado JP, Myklebust H, et al. Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA 2005;293:305- 10.
  • Peberdy MA, Ornato JP, Larkin GL, et al. Survival from in-hospital cardiac arrest during nights and weekends. JAMA 2008;299:785- 92.
  • Chan PS, Krumholz HM, Nichol G, et al. Delayed time to defibrillation after in-hospital cardiac arrest. N Engl J Med 2008;358:9-17.
  • Davies MJ. The pathophysiology of acute coronary syndromes. Heart 2000;83:361– 366.
  • Murat E, Toprak S, Doğan D.B, Mordoğan F. The Code Blue Experiences: Gains, Problems and Troubleshooting. Medicine Sciences 2014: 3(1):1002-12. .
  • Shin TG, Jo IJ, Song HG, et al. Improving survival rate of patients with in-hospital cardiac arrest: five years of experience in a single center in Korea. J Korean Med Sci 2012;27:146-52.

Entübasyon Hastane İçi Kardiyopulmoner Arrest Hastalarında Sağkalımı Etkiliyor mu?

Yıl 2022, Cilt: 5 Sayı: 3, 103 - 108, 30.09.2022
https://doi.org/10.54996/anatolianjem.1058127

Öz

Amaç: Kardiyopulmoner arrest, hastane içi morbidite ve mortaliteye anlamlı katkı sağlayan önemli bir halk sağlığı sorunudur. Bu çalışma, hastane mortalitesini etkileyen faktörleri belirlemeyi ve hastane içi kardiyopulmoner arrest geçiren hastalarda entübasyonun sağkalıma katkı sağlayıp sağlamadığını belirlemeyi amaçladı.


Gereç ve Yöntemler: Bu retrospektif, kesitsel çalışma, 1 Ocak 2014 ile 31 Aralık 2018 tarihleri arasında "Mavi Kod" çağrısı olan tüm hastaların olay bildirim formları incelenerek yapılmıştır. Müdahale sonrası ölen ve ölmeyen hastalar yaş, cinsiyet, çağrının yeri, zamanı ve yapılan müdahaleler açısından karşılaştırıldı. Tek
başına kardiyopulmoner resüsitasyon uygulanan hastalar ile kardiyopulmoner resüsitasyon + entübasyon yapılan hastalar hastane içi mortalite açısından karşılaştırıldı; p değerleri <0,05 istatistiksel olarak anlamlı kabul edildi.


Bulgular: Bu çalışmaya toplam 924 hasta dahil edildi. En sık arama %64,4 oranıyla hastanenin servislerinden yapıldı. Hastane içi ölüm oranı %42,4 idi. Hastane içi ölüm oranları yaşlılarda, fazla mesai ve servis çağrılarında, kardiyopulmoner resüsitasyon veya kardiyopulmoner resüsitasyon + entübasyon uygulananlarda anlamlı olarak daha yüksekti. CPR yapılan hastalarda entübasyon sağkalımı etkilemedi. Cinsiyet, yaş, arama zamanı ve müdahale, hastane içi mortalitenin önemli belirleyicileriydi.


Sonuç: Mavi Kod aramaları öncelikle hastane servislerinden mesai saatleri dışında yapılıyordu ve uygunsuz arama oranları yüksekti. Ayrıca yaş, yer ve çağrı zamanı ve müdahaleler hastane içi mortalite için bağımsız risk faktörleriydi; entübasyon, hastane içi kardiyopulmoner arrest geçiren hastalarda sağkalıma katkıda bulunmadı.

Kaynakça

  • Mapp A, Goldsack J, Carandang L, Buehler JW, Sonnad SS. Emergency codes: a study of hospital attitudes and practices. J Healthc Prot Manage. 2015;31(2):36-47.
  • Sandroni C, Nolan J, Cavallaro F, Antonelli M. In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intensive Care Med 2007;33:337-45.
  • Rakşc D, Rumboldt Z, Carevic V, Bagatin J, Polic S, Pivac N. In-hospital cardiac arrest and resuscitation outcomes: rationale for sudden cardiac death approach. Croat Med J. 2005;46:907-12. .
  • Jacobs I, Nadkarni V, Bahr J, Berg RA, Billi JE, Bossaert L et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries. Resuscitation. 2004;63:233-249.
  • Dane FC, Russell-Lindgren KS, Parish DC, Durham MD, Brown TD. Inhospital resuscitation: association between ACLS training and survival to discharge. Resuscitation. 2000;47:83-87. .
  • Koltka N, Çelik M, Yalman A, Süren M, Öztekin F. Kardiyopulmoner resüsitasyonun başarısına etkisi olan faktörler. Türk Anest Rean Der Dergisi. 2008;36(6):366-72. .
  • Sanders AB, Berg RA, Burress M, Genova RT, Kern KB, Ewy GA. The efficacy of an ACLS training program for resuscitation from cardiac arrest in a rural community. Ann Emerg Med. 1994;23:56-59.
  • Joint Commission on Accreditation of Healthcare Organization. Sentinal event statistics. June 29, 2004. Avaliable at: www.Jcaho.org/accredited+organisations/ambulatory+care/sentinel+even ts/sentinel+events+statistics.htm
  • Price JW, Applegarth O, Vu M, Price JR. Code blue emergencies: A team task analysis and educational Initiative. Canadian Med Educ J. 2012, 3(1).
  • Perkins GD, Oasveengen TM, Maconochie, Soar J et al. European resuscitation council guidelines for resuscitation: 2017 update Resuscitation. 2017;123:43-50. .
  • Newell C, Grier S, Soar J. Airway and ventilation management during cardiopulmonary resuscitation and after succesful resuscitation. Critical Care (2018) 22:190.
  • Soar J, Nolan JP, Bottiger BW, Perkins GD, Lott C, Carli P, Pellis T, Sandroni C, Skrifvars MB, Smith GB, et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation. 2015;95:100–47.
  • Voss S, Rhys M, Coates D, Greenwood R, Nolan JP, Thomas M, Benger J. How do paramedics manage the airway during out of hospital cardiac arrest? Resuscitation. 2014;85(12):1662–6. .
  • Olasveengen TM, de Caen AR, Mancini ME et al. 2017 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations summary. Resuscitation. 2017;121:201–14.
  • Donoghue AJ, Abella BS, Merchant R, et al. Cardiopulmonary resuscitation for in-hospital events in the emergency department: A comparison of adult and pediatric outcomes and care processes. Resuscitation. 2015;92:94–100.
  • Fouche PF, Simpson PM, Bendall J, Thomas RE, Cone DC, Doi SA. Airways in out-of-hospital cardiac arrest: systematic review and metaanalysis. Prehosp Emerg Care. 2014;18(2):244–56.
  • Jabre P, Penaloza A, Pinero D et al.Effect of bag-mask ventilation vs endotracheal intubation during cardiopulmonary resuscitation on neurological outcome after out-of-hospital cardiorespiratory arrest:a randomized clinical trial. JAMA.2018;319(8):779–87.
  • Andersen LW, Granfeldt A, Callaway CW et al. American Heart Association's get with the Guidelines- Resuscitation I. Association between tracheal intubation during adult inhospital cardiac arrest and survival. JAMA. 2017;317(5):494–506.
  • Meaney PA, Bobrow BJ, Mancini ME, et al. Cardiopulmonary resuscitation quality: improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation. 2013;128:417–435.
  • Kuday Kaykısız E, Tongün A, Sönmezsoy M, Güven R. Code Blue in Theory Versus Daily Practice: Data from a Secondary Care Hospital. Eurasian J Emerg Med 2017;16(4):157-161.
  • Bayramoglu A, Cakir ZG, Akoz A, Ozogul B, Aslan Ş, Saritemur M. Patient-Staff Safety Applications: The Evaluation of Blue Code Reports. Eurasian J Med 2013; 45: 163-6.
  • Eroglu SE, Onur Ö, Urgan O, Denizbasi A, Akoglu H. Blue code: Is it a real emergency? World J Emerg Med 2014; 5: 20-3.
  • Çiçekçi F, Atıcı S.S. Mavi kod çağrılarına bağlı kardiyo-pulmoner resüsitasyon uygulamaları sonuçlarının değerlendirilmesi. Genel Tıp Derg 2013;23(3):70-6.
  • Brindley PG, Markland DM, Mayers I, et al. Predictors of survival following in-hospital adult cardiopulmonary resuscitation. CMAJ 2002;167:343-8.
  • Abella BS, Alvarado JP, Myklebust H, et al. Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA 2005;293:305- 10.
  • Peberdy MA, Ornato JP, Larkin GL, et al. Survival from in-hospital cardiac arrest during nights and weekends. JAMA 2008;299:785- 92.
  • Chan PS, Krumholz HM, Nichol G, et al. Delayed time to defibrillation after in-hospital cardiac arrest. N Engl J Med 2008;358:9-17.
  • Davies MJ. The pathophysiology of acute coronary syndromes. Heart 2000;83:361– 366.
  • Murat E, Toprak S, Doğan D.B, Mordoğan F. The Code Blue Experiences: Gains, Problems and Troubleshooting. Medicine Sciences 2014: 3(1):1002-12. .
  • Shin TG, Jo IJ, Song HG, et al. Improving survival rate of patients with in-hospital cardiac arrest: five years of experience in a single center in Korea. J Korean Med Sci 2012;27:146-52.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Orijinal Çalışma
Yazarlar

Metin Yadigaroğlu 0000-0003-1771-5523

Burak Katipoglu 0000-0002-7950-824X

Olgun Aşık 0000-0002-3909-1427

Mustafa Sabak 0000-0003-2777-2003

Yayımlanma Tarihi 30 Eylül 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 5 Sayı: 3

Kaynak Göster

AMA Yadigaroğlu M, Katipoglu B, Aşık O, Sabak M. Does Intubation Affect Survival Among Patients Experiencing In-Hospital Cardiopulmonary Arrest?. Anatolian J Emerg Med. Eylül 2022;5(3):103-108. doi:10.54996/anatolianjem.1058127