TY - JOUR
T1 - Survival of in‐hospital cardiac arrest in covid‐19 infected patients
AU - Aldabagh, Mohammad
AU - Wagle, Sneha
AU - Cesa, Marie
AU - Yu, Arlene
AU - Farooq, Muhammad
AU - Goldberg, Ythan
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/10
Y1 - 2021/10
N2 - Background: There are limited data regarding the outcome of in‐hospital cardiopulmonary resuscitation (CPR) in COVID‐19 patients. In this study, we compared the outcomes of in‐hospital cardiac arrests (IHCA) before and at the peak of the COVID‐19 pandemic at Montefiore Medical Center in the Bronx, New York, United States. We also identified the most common comorbidities associated with poor outcomes in our community. Methods: This was a multi‐site, single‐center, retrospective, observational study. Inclusion criteria for COVID patients were all confirmed positive cases who had in‐hospital cardiac arrest (IHCA) between 1 March 2020 and 30 June 2020. The non‐ COVID cohort included all cardiac arrest cases who had IHCA in 2019. We excluded all out‐of-hospital cardiac arrest (OHCA). We compared actual survival to that predicted by the GO‐FAR score, a validated prediction model for determining survival following IHCA. Results: There were 334 cases in 2019 compared to 450 cases during the specified period in 2020. Patients who initially survived cardiac arrest but then had their code statuses changed to do not resuscitate (DNR) were excluded. Groups were similar in terms of sex distribution, and both had an average age of about 66 years. Seventy percent of COVID patients were of Black or Hispanic ethnicity. A shockable rhythm was present in 7% of COVID patients and 17% of non‐COVID patients (p < 0.05). COVID patients had higher BMI (30.7 vs. 28.4, p < 0.05), higher prevalence of diabetes mellitus (58% vs. 38%, p < 0.05), and lower incidence of coronary artery disease (22% vs. 35%, p < 0.05). Both groups had almost similar predicted average survival rates based on the GO‐FAR score, but only 1.5% of COVID patients survived to discharge compared to 7% of non‐COVID patients (p < 0.05). Conclusion: The rate of survival to hospital discharge in COVID‐19 patients who suffer IHCA is worse than in non‐COVID patients, and lower than that predicted by the GO‐FAR score. This finding may help inform our patient population about risk factors associated with high mortality in COVID‐19 infection, as well as educate hospitalized patients and healthcare proxies in the setting of code status designation.
AB - Background: There are limited data regarding the outcome of in‐hospital cardiopulmonary resuscitation (CPR) in COVID‐19 patients. In this study, we compared the outcomes of in‐hospital cardiac arrests (IHCA) before and at the peak of the COVID‐19 pandemic at Montefiore Medical Center in the Bronx, New York, United States. We also identified the most common comorbidities associated with poor outcomes in our community. Methods: This was a multi‐site, single‐center, retrospective, observational study. Inclusion criteria for COVID patients were all confirmed positive cases who had in‐hospital cardiac arrest (IHCA) between 1 March 2020 and 30 June 2020. The non‐ COVID cohort included all cardiac arrest cases who had IHCA in 2019. We excluded all out‐of-hospital cardiac arrest (OHCA). We compared actual survival to that predicted by the GO‐FAR score, a validated prediction model for determining survival following IHCA. Results: There were 334 cases in 2019 compared to 450 cases during the specified period in 2020. Patients who initially survived cardiac arrest but then had their code statuses changed to do not resuscitate (DNR) were excluded. Groups were similar in terms of sex distribution, and both had an average age of about 66 years. Seventy percent of COVID patients were of Black or Hispanic ethnicity. A shockable rhythm was present in 7% of COVID patients and 17% of non‐COVID patients (p < 0.05). COVID patients had higher BMI (30.7 vs. 28.4, p < 0.05), higher prevalence of diabetes mellitus (58% vs. 38%, p < 0.05), and lower incidence of coronary artery disease (22% vs. 35%, p < 0.05). Both groups had almost similar predicted average survival rates based on the GO‐FAR score, but only 1.5% of COVID patients survived to discharge compared to 7% of non‐COVID patients (p < 0.05). Conclusion: The rate of survival to hospital discharge in COVID‐19 patients who suffer IHCA is worse than in non‐COVID patients, and lower than that predicted by the GO‐FAR score. This finding may help inform our patient population about risk factors associated with high mortality in COVID‐19 infection, as well as educate hospitalized patients and healthcare proxies in the setting of code status designation.
KW - COVID
KW - Cardiac arrest
KW - Pandemic
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U2 - 10.3390/healthcare9101315
DO - 10.3390/healthcare9101315
M3 - Article
AN - SCOPUS:85116862062
SN - 2227-9032
VL - 9
JO - Healthcare (Switzerland)
JF - Healthcare (Switzerland)
IS - 10
M1 - 1315
ER -