Predictors and Outcomes of Cardiac Arrest in the Emergency Department of a University Hospital in Turkey

Background and Aim: İn hospital cardiac arrests are treated in the emergency department at a rate of about 10%. Survivalvaries, although those who arrests in the emergency department are likely to have a higher chance for survival. This studyaims to determine the incidence, demographics, clinical characteristics, and outcomes of patients with cardiac arrest inthe adult emergency department.Methods: Between January 1, 2018, and December 31, 2019, 552 patients were included who were spontaneously circulating and breathing on arrival but later suffered cardiac arrest during emergency department observation. Data werecollected from electronic and manual nurse observation files, including age, comorbidities, pre-cardiac arrest vital signs,treatments, CPR details, and outcomes. Modified Charlson Comorbidity Index (mCCI) scores were calculated and associations with CPR, 24-hour, and 30-day outcomes were examined.Results: Of the 552 patients, 53.6% were male, with a mean age of 79 (IQR: 68-86) years. Shortness of breath was themost common complaint (35.1%). The median mCCI score was 6. Most patients (50.7%) were in the monitoring ward, and95.5% suffered cardiac arrest there. The most common etiology was medical-noncardiac (73.6%). More than half receivedvasopressor support, and mechanical ventilation was common. The median observation time to cardiac arrest was 11.8hours. Duration of CPR averaged 20 minutes, with a median of 7 epinephrine administrations. Shockable rhythms were rare(7.7%). All received chest compressions, two of them mechanical CPR. No extracorporeal CPR was performed. The mostcommon causes of cardiac arrest were pneumonia, septic shock, and malignancy. Outcomes included ROSC (32.6%), 24-hour survival (13.2%), and 30-day survival (4.7%, 3.1% discharged).</p