Outcomes of in-hospital cardiac arrests during and after office hours in a single tertiary centre in Singapore

Abstract

Abstract Introduction: In-hospital cardiac arrest (IHCA) is a significant healthcare burden with a paucity of data in Singapore. Various factors, including time of cardiac arrest, affect survival from acute resuscitation. Methods: This was a retrospective cohort study that evaluated the characteristics of patients who sustained an IHCA, including the Cardiac Arrest Survival Post Resuscitation In-hospital (CASPRI) scores, and the impact of arrest time in 220 consecutive cardiac arrests occurring in a tertiary hospital. The primary outcome was rate of return of spontaneous circulation (ROSC) post-IHCA, and the secondary outcome was 90-day survival. Results: The ROSC rate among patients with IHCA out of and during office hours was 69.5% and 75.4%, respectively (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.39–1.42). There were no statistically significant differences between the CASPRI scores of both groups. After adjusted analysis, the OR of ROSC post-IHCA out of office hours as compared to that during office hours was 0.78 (95% CI 0.39–1.53). The 90-day survival rate of patients who had an IHCA out of and during office hours was 25.7% and 34.6%, respectively (OR 0.65, 95% CI 0.32–1.34). The adjusted OR of 90-day survival was 0.66 (0.28–1.59). Conclusion: The results of this observational study did not show an association between the timing of cardiac arrest and the rate of ROSC or 90-day survival.