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ICU cardiac arrest circumstances might predict survival

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The circumstances of cardiac arrest suffered by patients in ICUs may predict their long-term survival rate, according to a study in the Canadian Medical Association Journal.

Researchers with the University of Alberta sought to understand survival rates for people who suffer cardiac arrest in the ICU. They looked at data covering January 2000 to April 2005 from four Alberta hospitals with coronary care units and general ICUs, including survival rates at one and five years as well as short-term rates.

The study included 517 patients, with 62% male participants and an average age of 67. Of these, 27% survived to hospital discharge, 24% to one year and 16% to five years. General intensive care patients were more likely to die in the ICU compared to coronary care or cardiac surgical ICU patients. The time of day of cardiac arrest did not affect survival to discharge.

Factors associated with a high risk of death after cardiac arrest in the ICU included pulseless electrical activity or asystolic arrest, longer duration of resuscitation and decreased long-term survival with advanced age.

“Although overall survival among ICU patients may have greatly improved, survival among those experiencing cardiac arrest in the ICU, particularly arrest due to pulseless electrical activity or asystole, remained comparatively poor,” the authors wrote.

“We hope this study will help inform the public about outcomes after arrests in hospital intensive and coronary care units. It is hoped that improved informed decision-making regarding end-of-life resuscitation attempts may occur between patients, families and their physicians prior to serious illness and potential coronary or ICU care.”

To download a PDF of the study, visit http://www.cmaj.ca/content/early/2011/08/15/cmaj.100034.

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