Epidemiology, etiology, and outcomes of in-hospital cardiac arrest in Lebanon

Ahmed Eltarras; Youssef Jalloul; Ola Assaad; Michael Bejjani; Yara Yammine; Nina Khatib; Abdallah Rebeiz; Mazen El Sayed; Marwan Refaat

doi:10.11909/j.issn.1671-5411.2021.06.005

Volume 18 Issue 6

Jun. 2021

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Article Navigation > Journal of Geriatric Cardiology > 2021 > 18(6): 416-425

Please cite this article as: Eltarras A, Jalloul Y, Assaad O, Bejjani M, Yammine Y, Khatib N, A Rebeiz, M E Sayed, M Refaat. Epidemiology, etiology, and outcomes of in-hospital cardiac arrest in Lebanon. J Geriatr Cardiol 2021; 18(6): 416−425. DOI: 10.11909/j.issn.1671-5411.2021.06.005

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Please cite this article as: Eltarras A, Jalloul Y, Assaad O, Bejjani M, Yammine Y, Khatib N, A Rebeiz, M E Sayed, M Refaat. Epidemiology, etiology, and outcomes of in-hospital cardiac arrest in Lebanon. J Geriatr Cardiol 2021; 18(6): 416−425. DOI: 10.11909/j.issn.1671-5411.2021.06.005

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Epidemiology, etiology, and outcomes of in-hospital cardiac arrest in Lebanon

doi: 10.11909/j.issn.1671-5411.2021.06.005

1.
Geriatric Medicine Division, Saint Louis University School of Medicine, Missouri, USA
2.
Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
3.
Faculty of Medicine, American University of Beirut, Beirut, Lebanon
4.
School of Nursing, American University of Beirut, Beirut, Lebanon
5.
Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon

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Corresponding author: mr48@aub.edu.lb
Available Online: 2021-06-22
Publish Date: 2021-06-22

Abstract

Abstract

BACKGROUND In-hospital cardiac arrest (IHCA) constitutes a significant cause of morbidity and mortality. As data is scarce in the Middle East and Lebanon, we devised this study to shed some light on it to better inform both hospitals and policymakers about the magnitude and quality of IHCA care in Lebanon. METHODS We analyzed retrospective data from 680 IHCA events at the American University of Beirut Medical Center between July 1, 2016 and May 2, 2019. Sociodemographic variables included age and sex, in addition to the comorbidities listed in the Charlson comorbidity index. IHCA event variables were day, event location, time from activation to arrival, initial cardiac rhythm, and the total number of IHCA events. We also looked at the months and years. We considered the return of spontaneous circulation (ROSC) and survival to discharge (StD) to be our outcomes of interest. RESULTS The incidence of IHCA was 6.58 per 1,000 hospital admissions (95% CI: 6.09−7.08). Non-shockable rhythms were 90.7% of IHCAs. Most IHCA cases occurred in the closed units (87.9%) (intensive care unit, respiratory care unit, neurology care unit, and cardiology care unit) and on weekdays (76.5%). ROSC followed more than half the IHCA events (56%). However, only 5.4% of IHCA events achieved StD. Both ROSC and StD were higher in cases with a shockable rhythm. Survival outcomes were not significantly different between day, evening, and nightshifts. ROSC was not significantly different between weekdays and weekends; however, StD was higher in events that happened during weekdays than weekends (6.7% vs. 1.9%, P = 0.002). CONCLUSIONS The incidence of IHCA was high, and its outcomes were lower compared to other developed countries. Survival outcomes were better for patients who had a shockable rhythm and were similar between the time of day and days of the week. These findings may help inform hospitals and policymakers about the magnitude and quality of IHCA care in Lebanon.

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References(29)

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