Characterization of cardiac arrest in the emergency department of a Brazilian University Reference Hospital: A prospective study

Background & objectives: Sudden cardiac arrest (CA) represents one of the greatest challenges for medicine due to the vast number of cases and its social and economic impact. Despite advances in cardiopulmonary resuscitation (CPR) techniques, mortality rates have not significantly decreased over decades. This study was undertaken to characterize patients that have suffered CA and to identify factors related to mortality. Methods: This prospective study was conducted at Emergency Department of Sao Paulo Hospital, Brazil. Two hundred and eighty five patients were followed for one year after treatment for CA. The mean age was 66.3 +/- 17.2 yr, and they were predominantly male (55.8%) and Caucasian (71.9%). Mortality rate and factors associated with mortality were the primary and secondary outcome measures. Data were collected using an in-hospital Utstein-style report. A logistic regression analysis was used to determine which variables were related to mortality. Results: Regarding the characteristics of CPR, 76.5 per cent occurred in hospital, respiratory failure was the most common presumed immediate cause of CA (30.8%) and pulseless electrical activity was the most frequent initial rhythm (58.7%). All attempts at CPR utilized chest compressions and ventilation and the most utilized interventions were epinephrine (97.2%) and intubation (68.5%). Of all patients treated, 95.4 per cent died. Patients with pulseless electrical activity had a higher risk of death than those patients with ventricular fibrillation. Interpretation & conclusions: The findings of the study highlighted that the mortality rate among CA patients was high. The variable that best explained mortality was the initial CA rhythm.Univ Fed Sao Paulo, Paulista Sch Nursing, 754 Napoleao Barros St, BR-04024002 Sao Paulo, SP, BrazilUniv Fed Espirito Santo, 173 Feliciano Bicudo St, BR-02301020 Sao Paulo, SP, BrazilUniv Fed Goias, BR-74001970 Goiania, Go, BrazilUniv Fed Sao Paulo, 862 Botucatu St, BR-04023062 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Paulista Sch Med, 740 Botucatu St, BR-04023062 Sao Paulo, SP, BrazilPaulista School of Nursing/Universidade Federal de São Paulo (UNIFESP), 754 Napoleao de Barros Street, São Paulo, SP 04024-002, BrazilUniversidade Federal de São Paulo (UNIFESP), 862 Botucatu Street, Sao Paulo, SP 04023-062, BrazilPaulista School of Medicine/ Universidade Federal de São Paulo (UNIFESP), 740 Botucatu Street, Sao Paulo, SP 04023-062, BrazilWeb of Scienc