(1511) In-Hospital Cardiac Arrest in LMIC: A Comprehensive Analysis of Clinical Profiles and Outcomes

Introduction: In hospital cardiac arrest is associated with poor survival despite basic and advanced life support measures. This study aimed to identify the clinical characteristics and outcomes of cardiac arrests occurring during in-hospital admission to the tertiary care center in Pakistan.

Methods: This retrospective study examined 230 cardiac arrest patients at Aga Khan University Hospital between 2021 and 2023. Baseline demographics and clinical data, including the type of arrest, the timing of the arrest, the initial rhythm at the time of the arrest, the duration of resuscitation, and the location of the arrest were recorded. American Heart Association guidelines were followed for basic and advanced life support. The main outcome was death and survival to discharge from the hospital.

Results: 230 cardiac arrests were recorded during the study period. Among these 230 patients, 152 were adults and 78 were pediatric patients consisting of 85 females and 144 males. The mean age of adult patients was 57.8 (SD±17.9) while for the pediatric group, it was 4.99(SD±5.68). Respectively, the Charles comorbidity index was 2.88(SD±2.08) and 0.610(SD±0.88). In 152 adult arrest cases, 142 had shockable as the initial rhythm while the return of spontaneous circulation and survival to discharge rate were 52.6% and 28.3%. Similarly, for pediatrics, the most common initial rhythm was non-shockable at 85.9% while ROSC and survival to discharge rates were 51.3% and 17.9. Survival rates were lower for patients with a high Charles comorbidity index score, and a code time of more than 20 minutes.

Conclusions: The present study provides important observational data regarding in-hospital cardiac arrest outcomes challenging global survival averages. Factors like monitored units and rapid response teams contribute to higher survival rates. The study underscores the influence of comorbidities, rhythms, and code duration on outcomes, emphasizing the need for continued research in this context.