In-hospital cardiac arrest due to sepsis – Aetiologies and outcomes in a Swedish cohort study
Objectives: Awareness of causes of cardiac arrest is essential to prevent them. A recent review found that almost every sixth in-hospital cardiac arrest is caused by infection. Few studies have explored how infections cause cardiac arrest. Aim: To describe the features, mechanisms and outcome of sep...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520423001352 |
| _version_ | 1797429605155471360 |
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| author | Samuel Bruchfeld Ingrid Ronnow Felix Bergvich Frida Brochs Matilda Fahlen Kristoffer Strålin Therese Djärv |
| author_facet | Samuel Bruchfeld Ingrid Ronnow Felix Bergvich Frida Brochs Matilda Fahlen Kristoffer Strålin Therese Djärv |
| author_sort | Samuel Bruchfeld |
| collection | DOAJ |
| description | Objectives: Awareness of causes of cardiac arrest is essential to prevent them. A recent review found that almost every sixth in-hospital cardiac arrest is caused by infection. Few studies have explored how infections cause cardiac arrest. Aim: To describe the features, mechanisms and outcome of sepsis-related cardiac arrests. Material and methods: All patients ≥18 years who suffered a cardiac arrest at Karolinska University Hospital between 2007 and 2022 with sepsis as the primary cause were included. Data were collected the Swedish Registry for Cardiopulmonary Resuscitation and medical records. The primary outcome was survival to discharge. Results: Out of 2,327 in-hospital cardiac arrests, 5% (n = 123) suffered it due to sepsis, and 17% (21) survived to hospital discharge. Two thirds of patients were admitted to the hospital due to sepsis and suffered their cardiac arrest after a median of four days. About half (n = 59) had deranged vital signs before the event. Most were witnessed in general wards. In all, 47% (n = 58) had asystole and 24% (n = 30) as the first heart rhythm. The respiratory tract was the most common source of infection. Most patients were undergoing antibiotic therapy and one third had a positive microbiological culture with mixed gram-positive bacteria or Escherichia coli in the urine. Conclusion: Our results suggest that sepsis is an uncommon and not increasing cause of in-hospital cardiac arrest and its outcome is in line with other non-shockable cardiac arrests. Deranged respiratory and/or circulatory vital signs precede the event. |
| first_indexed | 2024-03-09T09:15:32Z |
| format | Article |
| id | doaj.art-231e454ef9dc47d19c6c7310b0b6e887 |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-03-09T09:15:32Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-231e454ef9dc47d19c6c7310b0b6e8872023-12-02T07:06:58ZengElsevierResuscitation Plus2666-52042023-12-0116100492In-hospital cardiac arrest due to sepsis – Aetiologies and outcomes in a Swedish cohort studySamuel Bruchfeld0Ingrid Ronnow1Felix Bergvich2Frida Brochs3Matilda Fahlen4Kristoffer Strålin5Therese Djärv6Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Emergency Department, Karolinska University Hospital, Stockholm, SwedenDepartment of Medicine Solna, Karolinska Institutet, Stockholm, SwedenDepartment of Medicine Solna, Karolinska Institutet, Stockholm, SwedenDepartment of Medicine Solna, Karolinska Institutet, Stockholm, SwedenDepartment of Medicine Solna, Karolinska Institutet, Stockholm, SwedenDepartment of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, SwedenDepartment of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Emergency Department, Karolinska University Hospital, Stockholm, Sweden; Corresponding author.Objectives: Awareness of causes of cardiac arrest is essential to prevent them. A recent review found that almost every sixth in-hospital cardiac arrest is caused by infection. Few studies have explored how infections cause cardiac arrest. Aim: To describe the features, mechanisms and outcome of sepsis-related cardiac arrests. Material and methods: All patients ≥18 years who suffered a cardiac arrest at Karolinska University Hospital between 2007 and 2022 with sepsis as the primary cause were included. Data were collected the Swedish Registry for Cardiopulmonary Resuscitation and medical records. The primary outcome was survival to discharge. Results: Out of 2,327 in-hospital cardiac arrests, 5% (n = 123) suffered it due to sepsis, and 17% (21) survived to hospital discharge. Two thirds of patients were admitted to the hospital due to sepsis and suffered their cardiac arrest after a median of four days. About half (n = 59) had deranged vital signs before the event. Most were witnessed in general wards. In all, 47% (n = 58) had asystole and 24% (n = 30) as the first heart rhythm. The respiratory tract was the most common source of infection. Most patients were undergoing antibiotic therapy and one third had a positive microbiological culture with mixed gram-positive bacteria or Escherichia coli in the urine. Conclusion: Our results suggest that sepsis is an uncommon and not increasing cause of in-hospital cardiac arrest and its outcome is in line with other non-shockable cardiac arrests. Deranged respiratory and/or circulatory vital signs precede the event.http://www.sciencedirect.com/science/article/pii/S2666520423001352IHCAAetiologiesSeptic shock |
| spellingShingle | Samuel Bruchfeld Ingrid Ronnow Felix Bergvich Frida Brochs Matilda Fahlen Kristoffer Strålin Therese Djärv In-hospital cardiac arrest due to sepsis – Aetiologies and outcomes in a Swedish cohort study Resuscitation Plus IHCA Aetiologies Septic shock |
| title | In-hospital cardiac arrest due to sepsis – Aetiologies and outcomes in a Swedish cohort study |
| title_full | In-hospital cardiac arrest due to sepsis – Aetiologies and outcomes in a Swedish cohort study |
| title_fullStr | In-hospital cardiac arrest due to sepsis – Aetiologies and outcomes in a Swedish cohort study |
| title_full_unstemmed | In-hospital cardiac arrest due to sepsis – Aetiologies and outcomes in a Swedish cohort study |
| title_short | In-hospital cardiac arrest due to sepsis – Aetiologies and outcomes in a Swedish cohort study |
| title_sort | in hospital cardiac arrest due to sepsis aetiologies and outcomes in a swedish cohort study |
| topic | IHCA Aetiologies Septic shock |
| url | http://www.sciencedirect.com/science/article/pii/S2666520423001352 |
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