Characteristics, therapies, and outcomes of In-Hospital vs Out-of-Hospital cardiac arrest in patients presenting to cardiac intensive care units: From the critical care Cardiology trials network (CCCTN).

Journal Article (Multicenter Study;Journal Article)

BACKGROUND: Cardiac arrest (CA) is a common reason for admission to the cardiac intensive care unit (CICU), though the relative burden of morbidity, mortality, and resource use between admissions with in-hospital (IH) and out-of-hospital (OH) CA is unknown. We compared characteristics, care patterns, and outcomes of admissions to contemporary CICUs after IHCA or OHCA. METHODS: The Critical Care Cardiology Trials Network is a multicenter network of tertiary CICUs in the US and Canada. Participating centers contributed data from consecutive admissions during 2-month annual snapshots from 2017 to 2021. We analyzed characteristics and outcomes of admissions by IHCA vs OHCA. RESULTS: We analyzed 2,075 admissions across 29 centers (50.3% IHCA, 49.7% OHCA). Admissions with IHCA were older (median 66 vs 62 years), more commonly had coronary disease (38.3% vs 29.7%), atrial fibrillation (26.7% vs 15.6%), and heart failure (36.3% vs 22.1%), and were less commonly comatose on CICU arrival (34.2% vs 71.7%), p < 0.001 for all. IHCA admissions had lower lactate (median 4.3 vs 5.9) but greater utilization of invasive hemodynamics (34.3% vs 23.6%), mechanical circulatory support (28.4% vs 16.8%), and renal replacement therapy (15.5% vs 9.4%); p < 0.001 for all. Comatose IHCA patients underwent targeted temperature management less frequently than OHCA patients (63.3% vs 84.9%, p < 0.001). IHCA admissions had lower unadjusted CICU (30.8% vs 39.0%, p < 0.001) and in-hospital mortality (36.1% vs 44.1%, p < 0.001). CONCLUSION: Despite a greater burden of comorbidities, CICU admissions after IHCA have lower lactate, greater invasive therapy utilization, and lower crude mortality than admissions after OHCA.

Full Text

Duke Authors

Cited Authors

  • Carnicelli, AP; Keane, R; Brown, KM; Loriaux, DB; Kendsersky, P; Alviar, CL; Arps, K; Berg, DD; Bohula, EA; Burke, JA; Dixson, JA; Gerber, DA; Goldfarb, M; Granger, CB; Guo, J; Harrison, RW; Kontos, M; Lawler, PR; Miller, PE; Nativi-Nicolau, J; Newby, LK; Racharla, L; Roswell, RO; Shah, KS; Sinha, SS; Solomon, MA; Teuteberg, J; Wong, G; van Diepen, S; Katz, JN; Morrow, DA

Published Date

  • February 2023

Published In

Volume / Issue

  • 183 /

Start / End Page

  • 109664 -

PubMed ID

  • 36521683

Pubmed Central ID

  • PMC9899313

Electronic International Standard Serial Number (EISSN)

  • 1873-1570

Digital Object Identifier (DOI)

  • 10.1016/j.resuscitation.2022.12.002


  • eng

Conference Location

  • Ireland