tetano
Editor, Senior Moderator
BMJ
. 2020 Sep 30;371:m3513.
doi: 10.1136/bmj.m3513.
In-hospital cardiac arrest in critically ill patients with covid-19: multicenter cohort study
Salim S Hayek[SUP] 1 [/SUP], Samantha K Brenner[SUP] 2 3 [/SUP], Tariq U Azam[SUP] 4 [/SUP], Husam R Shadid[SUP] 5 [/SUP], Elizabeth Anderson[SUP] 4 [/SUP], Hanna Berlin[SUP] 5 [/SUP], Michael Pan[SUP] 5 [/SUP], Chelsea Meloche[SUP] 5 [/SUP], Rafey Feroz[SUP] 5 [/SUP], Patrick O'Hayer[SUP] 5 [/SUP], Rayan Kaakati[SUP] 5 [/SUP], Abbas Bitar[SUP] 4 [/SUP], Kishan Padalia[SUP] 5 [/SUP], Daniel Perry[SUP] 4 [/SUP], Pennelope Blakely[SUP] 4 [/SUP], Shruti Gupta[SUP] 6 [/SUP], Shahzad Shaefi[SUP] 7 [/SUP], Anand Srivastava[SUP] 8 [/SUP], David M Charytan[SUP] 9 [/SUP], Anip Bansal[SUP] 10 [/SUP], Mary Mallappallil[SUP] 11 [/SUP], Michal L Melamed[SUP] 12 [/SUP], Alexandre M Shehata[SUP] 13 [/SUP], Jag Sunderram[SUP] 14 [/SUP], Kusum S Mathews[SUP] 15 [/SUP], Anne K Sutherland[SUP] 16 [/SUP], Brahmajee K Nallamothu[SUP] 4 [/SUP], David E Leaf[SUP] 6 [/SUP], STOP-COVID Investigators; STOP-COVID Investigators
Collaborators, Affiliations
Abstract
Objectives: To estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in critically ill adults with coronavirus disease 2019 (covid-19).
Design: Multicenter cohort study.
Setting: Intensive care units at 68 geographically diverse hospitals across the United States.
Participants: Critically ill adults (age ≥18 years) with laboratory confirmed covid-19.
Main outcome measures: In-hospital cardiac arrest within 14 days of admission to an intensive care unit and in-hospital mortality.
Results: Among 5019 critically ill patients with covid-19, 14.0% (701/5019) had in-hospital cardiac arrest, 57.1% (400/701) of whom received cardiopulmonary resuscitation. Patients who had in-hospital cardiac arrest were older (mean age 63 (standard deviation 14) v 60 (15) years), had more comorbidities, and were more likely to be admitted to a hospital with a smaller number of intensive care unit beds compared with those who did not have in-hospital cardiac arrest. Patients who received cardiopulmonary resuscitation were younger than those who did not (mean age 61 (standard deviation 14) v 67 (14) years). The most common rhythms at the time of cardiopulmonary resuscitation were pulseless electrical activity (49.8%, 199/400) and asystole (23.8%, 95/400). 48 of the 400 patients (12.0%) who received cardiopulmonary resuscitation survived to hospital discharge, and only 7.0% (28/400) survived to hospital discharge with normal or mildly impaired neurological status. Survival to hospital discharge differed by age, with 21.2% (11/52) of patients younger than 45 years surviving compared with 2.9% (1/34) of those aged 80 or older.
Conclusions: Cardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among older patients.
. 2020 Sep 30;371:m3513.
doi: 10.1136/bmj.m3513.
In-hospital cardiac arrest in critically ill patients with covid-19: multicenter cohort study
Salim S Hayek[SUP] 1 [/SUP], Samantha K Brenner[SUP] 2 3 [/SUP], Tariq U Azam[SUP] 4 [/SUP], Husam R Shadid[SUP] 5 [/SUP], Elizabeth Anderson[SUP] 4 [/SUP], Hanna Berlin[SUP] 5 [/SUP], Michael Pan[SUP] 5 [/SUP], Chelsea Meloche[SUP] 5 [/SUP], Rafey Feroz[SUP] 5 [/SUP], Patrick O'Hayer[SUP] 5 [/SUP], Rayan Kaakati[SUP] 5 [/SUP], Abbas Bitar[SUP] 4 [/SUP], Kishan Padalia[SUP] 5 [/SUP], Daniel Perry[SUP] 4 [/SUP], Pennelope Blakely[SUP] 4 [/SUP], Shruti Gupta[SUP] 6 [/SUP], Shahzad Shaefi[SUP] 7 [/SUP], Anand Srivastava[SUP] 8 [/SUP], David M Charytan[SUP] 9 [/SUP], Anip Bansal[SUP] 10 [/SUP], Mary Mallappallil[SUP] 11 [/SUP], Michal L Melamed[SUP] 12 [/SUP], Alexandre M Shehata[SUP] 13 [/SUP], Jag Sunderram[SUP] 14 [/SUP], Kusum S Mathews[SUP] 15 [/SUP], Anne K Sutherland[SUP] 16 [/SUP], Brahmajee K Nallamothu[SUP] 4 [/SUP], David E Leaf[SUP] 6 [/SUP], STOP-COVID Investigators; STOP-COVID Investigators
Collaborators, Affiliations
- PMID: 32998872
- DOI: 10.1136/bmj.m3513
Abstract
Objectives: To estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in critically ill adults with coronavirus disease 2019 (covid-19).
Design: Multicenter cohort study.
Setting: Intensive care units at 68 geographically diverse hospitals across the United States.
Participants: Critically ill adults (age ≥18 years) with laboratory confirmed covid-19.
Main outcome measures: In-hospital cardiac arrest within 14 days of admission to an intensive care unit and in-hospital mortality.
Results: Among 5019 critically ill patients with covid-19, 14.0% (701/5019) had in-hospital cardiac arrest, 57.1% (400/701) of whom received cardiopulmonary resuscitation. Patients who had in-hospital cardiac arrest were older (mean age 63 (standard deviation 14) v 60 (15) years), had more comorbidities, and were more likely to be admitted to a hospital with a smaller number of intensive care unit beds compared with those who did not have in-hospital cardiac arrest. Patients who received cardiopulmonary resuscitation were younger than those who did not (mean age 61 (standard deviation 14) v 67 (14) years). The most common rhythms at the time of cardiopulmonary resuscitation were pulseless electrical activity (49.8%, 199/400) and asystole (23.8%, 95/400). 48 of the 400 patients (12.0%) who received cardiopulmonary resuscitation survived to hospital discharge, and only 7.0% (28/400) survived to hospital discharge with normal or mildly impaired neurological status. Survival to hospital discharge differed by age, with 21.2% (11/52) of patients younger than 45 years surviving compared with 2.9% (1/34) of those aged 80 or older.
Conclusions: Cardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among older patients.