In-Hospital Cardiac Arrests in the U.S. May Be Underestimated
WEDNESDAY, July 24, 2019 -- More patients suffer cardiac arrest in U.S. hospitals each year than previously estimated -- about 38 percent greater for adults and 18 percent greater for children, according to a study published online July 9 in Circulation: Cardiovascular Quality and Outcomes.
Using the Get With the Guidelines-Resuscitation registry, Mathias J. Holmberg, M.D., M.P.H., from the Aarhus University Hospital in Denmark, and colleagues estimated the incidence of index pulseless in-hospital cardiac arrest based on hospital-level characteristics in all U.S. hospitals. The authors performed separate analyses for adult (≥18 years) and pediatric (<18 years) cardiac arrests. Additional analyses were performed for recurrent cardiac arrests, as well as for pediatric patients requiring cardiopulmonary resuscitation for poor perfusion (nonpulseless events).
The researchers estimated the average annual incidence of in-hospital cardiac arrest in the United States to be 292,000 adult and 15,200 pediatric cases, of which 7,100 and 8,100 were pulseless cardiac arrests and nonpulseless events, respectively. While the rate of pediatric events remained fairly stable, the rate of adult cardiac arrests increased over time. When including both index and recurrent in-hospital cardiac arrests, the average annual incidence was estimated to be 357,900 adult and 19,900 pediatric cases, of which 8,300 and 11,600 were pulseless cardiac arrests and nonpulseless events, respectively.
"Our findings illustrate a concerning trend in U.S. hospitals, and show that cardiac arrest is a major public health problem," a coauthor said in a statement. "Previous incidence estimates may no longer reflect the current public health burden of cardiac arrest in hospitalized patients across the United States."
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Posted: July 2019
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