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

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 contrib...

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Bibliographic Details
Published in:Resuscitation 2014-08, Vol.85 (8), p.987-992
Main Authors: Nolan, Jerry P, Soar, Jasmeet, Smith, Gary B, Gwinnutt, Carl, Parrott, Francesca, Power, Sarah, Harrison, David A, Nixon, Edel, Rowan, Kathryn
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Cardiac arrest
Cardiopulmonary resuscitation
Cardiopulmonary Resuscitation - methods
Clinical Audit
Emergency
Epidemiology
Female
Follow-Up Studies
Heart Arrest - epidemiology
Heart Arrest - therapy
Hospital Mortality - trends
Humans
In-hospital cardiac arrest
Incidence
Male
Middle Aged
Outcome
Prospective Studies
Registries
Survival Rate - trends
Treatment Outcome
United Kingdom - epidemiology
Young Adult
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Summary: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.
ISSN:0300-9572
1873-1570
DOI:10.1016/j.resuscitation.2014.04.002