Chest
Clinical InvestigationsClinical Antecedents to In-Hospital Cardiopulmonary Arrest
Section snippets
Methods
Over a four-month period (July through October 1987), patients developing arrest on the general inpatient services of the Jackson Memorial Hospital Medical Center, a 1,200-bed University-affiliated county and tertiary care facility, were studied. Patients were identified by daily interviews of the hospital's cardiac arrest team physicians and daily monitoring of all patients admitted to intensive care units or placed on ventilators. Patients developing arrest in the operating or recovery rooms,
Results
Sixty-four patients were identified as having cardiopulmonary arrest during the study period. Of these, 59 (92 percent) had cessation of both respiratory and cardiac function while five (8 percent) had respiratory arrest alone. The mean age of patients was 51±2 years. Forty-four patients (69 percent) were male. Arrest occurred a mean of 161±26 hours (range, 4 to 1,026 hours) after hospital admission. Fifty-seven arrests occurred on the general and subspecialty Internal Medicine and Family
Discussion
We have studied a group of patients who had cardiopulmonary arrest on the general ward services with an emphasis on events preceding arrest. The classification of the underlying pathophysiologic abnormalities was determined conservatively by the use of definitions requiring significant and progressive derangements. Despite this, only six patients failed to meet criteria for one of the diagnostic categories and 18 met criteria for more than one category. The most common abnormalities were those
ACKNOWLEDGMENTS
The authors are indebted to the nursing, respiratory therapy, and house staffs of Jackson Memorial Hospital for their assistance and to Janis W. Kampka for her technical assistance.
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Presented in part at the 17th Annual Society of Critical Care Medicines Educational and Scientific Symposium, May 1988, and published in abstract form in Crit Care Med 1988; 16:385.
Manuscript received November 22, 1989; revision accepted May 21.