A comparison between patients suffering in-hospital and out-of-hospital cardiac arrest in terms of treatment and outcome
Article first published online: 25 DEC 2001
Journal of Internal Medicine
Volume 248, Issue 1, pages 53–60, July 2000
How to Cite
Herlitz, J., Bång, A., Ekström, L., Aune, S., Lundström, G., Holmberg, S., Holmberg, M. and Lindqvist, J. (2000), A comparison between patients suffering in-hospital and out-of-hospital cardiac arrest in terms of treatment and outcome. Journal of Internal Medicine, 248: 53–60. doi: 10.1046/j.1365-2796.2000.00702.x
- Issue published online: 25 DEC 2001
- Article first published online: 25 DEC 2001
- cardiac arrest;
Abstract. Herlitz J, Bång A, Ekström L, Aune S, Lundström G, Holmberg S, Holmberg M, Lindqvist J (Sahlgrenska University Hospital, Göteborg, Sweden). A comparison between patients suffering in-hospital and out-of-hospital cardiac arrest in terms of treatment and outcome. J Intern Med 2000; 248: 53–60.
Aim. To compare treatment and outcome amongst patients suffering in-hospital and out-of-hospital cardiac arrest in the same community.
Patients. All patients suffering in-hospital cardiac arrest in Sahlgrenska University Hospital covering half the catchment area of the community of Göteborg (500 000 inhabitants) and all patients suffering out-of-hospital cardiac arrest in the community of Göteborg. Criteria for inclusion were that resuscitation efforts should have been attempted.
Time of survey. From 1 November 1994 to 1 November 1997.
Methods. Data were recorded both prospectively and retrospectively.
Results. In total, 422 patients suffered in-hospital cardiac arrest and 778 patients suffered out-of-hospital cardiac arrest. Patients with in-hospital cardiac arrest included more women and were more frequently found in ventricular fibrillation. The median interval between collapse and defibrillation was 2 min in in-hospital cardiac arrest compared with 7 min in out-of-hospital cardiac arrest (< 0.001). The proportion of patients being discharged from hospital was 37.5% after in-hospital cardiac arrest, compared with 8.7% after out-of-hospital cardiac arrest (P < 0.001). Corresponding figures for patients found in ventricular fibrillation were 56.9 vs. 19.7% (P < 0.001) and for patients found in asystole 25.2 vs. 1.8% (P < 0.001).
Conclusion. In a survey evaluating patients with in-hospital and out-of-hospital cardiac arrest in whom resuscitation efforts were attempted, we found that the former group had a survival rate more than four times higher than the latter. Possible strong contributing factors to this observation are: (i) shorter time interval to start of treatment, and (ii) a prepared selection for resuscitation efforts.