Factors related to the return of spontaneous circulation in sudden cardiac arrest at a Tertiary Care Hospital in Lower Northern Region
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Abstract
This research is a retrospective analytic study aimed at investigating related factors and the outcomes of cardiac arrest patients who received cardiopulmonary resuscitation (CPR) in a tertiary hospital in the lower northern region of Thailand. The study reviewed medical records of cardiac arrest patients between January 1,2018 and December 31,2020 and identified a total of 132 cases of successful resuscitation, with a return of spontaneous circulation (ROSC) rate of 37.9% within the first 24 hours after CPR and a survival rate of 25.8% to discharge. The most common electrocardiogram finding was asystole/pulseless electrical activity (71.2%). The average time to defibrillation was 5.27 ± 1.01 minutes. The total duration of CPR was 17.46 ± 1.44 minutes. The most common causes of cardiac arrest were acidosis (52.3%), hypoxia (40.2%), and coronary thrombosis (35.1%). Factors related to a decreased ROSC as determined by Multiple Logistic Regression included dyslipidemia with an adjusted odds ratio (AOR) of 0.27 (95%CI : 0.10 - 0.76, p = 0.013), hypovolemia with an AOR of 0.15 (95%CI : 0.03 - 0.77, p = 0.023),and hypoxia with an AOR of 0.27 (95%CI : 0.10 - 0.76, p = 0.014). Additionally, it was observed that the presence of ventricular fibrillation or pulseless ventricular tachycardia (VF/pVT) had a positive effect on increasing survival to discharge, with an AOR of 2.98 (95%CI: 1.11 - 7.97, p = 0.030), in comparison to asystole/PEA. The total duration of CPR had a negative effect on survival to discharge with an AOR of 0.95 (95%CI : 0.92 - 0.99, p = 0.009) for every one – minute increase. Moreover, factors related to both the patient and the treatment were identified to significantly affect the survival of patients with cardiac arrest. From this research, it is found that each additional minute in the total of duration of life – saving decreases the ROSC rate. Therefore, prompt and effective CPR is important and affects the chances of survival following in – hospital cardiac arrest.
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