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Temporal trends in cardiac arrest incidence and outcome in Finnish intensive care units from 2003 to 2013

I. Efendijev| R. Raj| M. Reinikainen| S. Hoppu| M. B. Skrifvars
Original
Volume 40, Issue 12 / December , 2014

Pages 1853 - 1861

Abstract

Purpose

To estimate temporal trends in incidence and hospital mortality after cardiac arrest in Finnish intensive care units.

Methods

Using a large nationwide intensive care unit (ICU) database we identified patients suffering from cardiac arrest following ICU admission (ICU-CA) during the study period (2003–2013). ICU-CA was defined as need for cardiopulmonary resuscitation and/or defibrillation (non-arrest cardioversions were excluded) according to the Therapeutic Intervention Scoring System-76. Patients admitted with an admission diagnosis of cardiac arrest were excluded. We determined crude incidence and risk-adjusted hospital mortality (based on a customized severity of illness model) for all ICU-CA patients, and for predefined admission diagnosis subgroups. Temporal trends for the observed period were calculated for crude incidence and risk-adjusted hospital mortality.

Results

Crude incidence for all ICU-CA patients was 29/1,000 ICU admissions, with the highest incidence 118/1,000 in the non-operative cardiovascular subgroup. Overall hospital mortality for ICU-CA patients was 55.5 % [95 % confidence interval (CI) 54–57 %]. Hospital mortality was 53.1 % (95 % CI 50.4–55.8 %) for non-operative cardiovascular ICU-CA patients, 32.9 % (95 % CI 26.9–38.9 %) for post cardiac surgery ICU-CA patients, and 56.3 % (95 % CI 51.2–61.3 %) for neurological/neurosurgical ICU-CA patients. There was a significant reduction in the overall ICU-CA incidence and in the risk-adjusted hospital mortality of ICU-CA and non-cardiac arrest cases (non-CA) over the observed study period (p < 0.001).

Conclusion

Our data suggest that the incidence of ICU-CA has decreased in Finnish ICUs between 2003 and 2013. Similar reduction in hospital mortality over time was observed for both ICU-CA and non-CA populations.

Keywords

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