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In-Hospital Cardiac Arrest in Patients with Covid-19: A Population-Based Study
Critical Care Medicine ; 51(1 Supplement):101, 2023.
Article in English | EMBASE | ID: covidwho-2190490
ABSTRACT

INTRODUCTION:

Recent reports suggest very low to no hospital survival among COVID-19 patients with in-hospital cardiac arrest (IHCA). However, studies to date included generally very small number of IHCA events and were often single-centered. The population-level outcomes of IHCA among COVID-19 patients is unknown. METHOD(S) We used a statewide data set to identify hospitalizations aged >=18 years in acute care hospitals in Texas with a diagnosis of COVID-19 between April 1st and December 31st, 2020. COVID-19 infection was identified using ICD-10 code U071. Cardiopulmonary resuscitation was identified using ICD-10 code 5A12012. Hospitalizations with cardiac arrest as a primary diagnosis and those without a primary diagnosis of COVID-19 were excluded. Mixed-effects multivariable logistic regression modelling was used to identify predictors of hospital survival among those with IHCA. RESULT(S) Among 65,482 hospitalizations with COVID-19, 893 (1.4%) had IHCA. Among those with IHCA, 57.1% were aged >= 65 years, 64.2% male, 70.9% racial/ethnic minority, and 7.1% had shockable rhythm. IHCA occurred in 12.7% [95% CI 11.8-13.6] of terminal hospitalizations. Hospital survival was 7.3% [95%CI 5.6-9.3], ranging from 6.7% [95% CI 4.6-9.3] among those aged >=65 years to 10.7% [95% CI 4.6-21.0] among those aged < 45 years. On adjusted analyses, among examined patient and hospital characteristics, only shockable rhythm (adjusted odds ratio [aOR] 2.63 [95% CI 1.05-6.56]) and management in hospitals with 200-399 beds (aOR 0.14 [95% CI 0.03- 0.58]), but not demographics, comorbidities, or illness severity, were associated with hospital survival. Among hospital survivors, 23.1% were transferred to hospice and 35.4% were discharged home. CONCLUSION(S) Resuscitation of IHCA among COVID-19 patients occurred more selectively compared to the general population. Hospital survival was very low, and less than 3% of those with IHCA were discharged home. Once developing among patients with COVID-19, the short-term survival of IHCA was no longer affected by demographic characteristics, comorbidity burden, or illness severity. Further large studies, using granular data, are needed to better guide clinicians', patients', and surrogates' decision-making and to improve patients' outcomes.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Critical Care Medicine Year: 2023 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Critical Care Medicine Year: 2023 Document Type: Article