In-hospital cardiac arrest in critically ill patients with covid-19: multicenter cohort study.
BMJ
; 371: m3513, 2020 09 30.
Article
in English
| MEDLINE | ID: covidwho-808184
ABSTRACT
OBJECTIVES:
To estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in critically ill adults with coronavirus disease 2019 (covid-19).DESIGN:
Multicenter cohort study.SETTING:
Intensive care units at 68 geographically diverse hospitals across the United States.PARTICIPANTS:
Critically ill adults (age ≥18 years) with laboratory confirmed covid-19. MAIN OUTCOMEMEASURES:
In-hospital cardiac arrest within 14 days of admission to an intensive care unit and in-hospital mortality.RESULTS:
Among 5019 critically ill patients with covid-19, 14.0% (701/5019) had in-hospital cardiac arrest, 57.1% (400/701) of whom received cardiopulmonary resuscitation. Patients who had in-hospital cardiac arrest were older (mean age 63 (standard deviation 14) v 60 (15) years), had more comorbidities, and were more likely to be admitted to a hospital with a smaller number of intensive care unit beds compared with those who did not have in-hospital cardiac arrest. Patients who received cardiopulmonary resuscitation were younger than those who did not (mean age 61 (standard deviation 14) v 67 (14) years). The most common rhythms at the time of cardiopulmonary resuscitation were pulseless electrical activity (49.8%, 199/400) and asystole (23.8%, 95/400). 48 of the 400 patients (12.0%) who received cardiopulmonary resuscitation survived to hospital discharge, and only 7.0% (28/400) survived to hospital discharge with normal or mildly impaired neurological status. Survival to hospital discharge differed by age, with 21.2% (11/52) of patients younger than 45 years surviving compared with 2.9% (1/34) of those aged 80 or older.CONCLUSIONS:
Cardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among older patients.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Hospital Mortality
/
Coronavirus Infections
/
Betacoronavirus
/
Heart Arrest
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Topics:
Long Covid
/
Variants
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
North America
Language:
English
Journal:
BMJ
Journal subject:
Medicine
Year:
2020
Document Type:
Article
Affiliation country:
Bmj.m3513
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