Does Intubation Affect Survival Among Patients Experiencing In-Hospital Cardiopulmonary Arrest?

Yıl 2022, , 103 - 108, 30.09.2022

Metin Yadigaroğlu , Burak Katipoglu , Olgun Aşık , Mustafa Sabak

https://doi.org/10.54996/anatolianjem.1058127

Cited By: 1

Öz

Aim: Cardiopulmonary arrest is an important public health problem that contributes substantially to in-hospital morbidity and mortality. The present study aimed to determine the factors that affect in-hospital mortality and determine whether intubation contributes to survival among patients experiencing in-hospital cardiopulmonary arrest.

Material and Methods: This retrospective, cross-sectional study was conducted by examining the event notification forms of all patients with a "Code Blue" call between January 1, 2014, and December 31, 2018. Patients who died and those who did not die after intervention were compared concerning age, sex, location and time of the call, and interventions implemented. Patients who received cardiopulmonary resuscitation alone and those who received cardiopulmonary resuscitation + intubation were compared concerning in-hospital mortality; p-values < 0.05 were considered statistically significant.

Results: In total, 924 patients were included in the present study. The most frequent calls were made from the wards in the hospital, at a rate of 64.4%. The in-hospital mortality rate was 42.4%. In-hospital mortality rates were significantly higher in the elderly, in those who were given overtime and service calls, and in
those who received cardiopulmonary resuscitation or cardiopulmonary resuscitation + intubation. Among patients who received CPR, intubation did not affect survival. Sex, age, time of call, and intervention were significant predictors of in-hospital mortality.

Conclusion: Code blue calls occurred primarily in the hospital wards outside of working hours, and improper call rates were high. Moreover, age, location and time of call, and interventions were independent risk factors for in-hospital mortality; intubation did not contribute to survival among patients experiencing in-hospital cardiopulmonary arrest.

Anahtar Kelimeler

Cardiopulmonary arrest, cardiopulmonary resuscitation, intubation, survival, in-hospital mortality

Entübasyon Hastane İçi Kardiyopulmoner Arrest Hastalarında Sağkalımı Etkiliyor mu?

Öz

Amaç: Kardiyopulmoner arrest, hastane içi morbidite ve mortaliteye anlamlı katkı sağlayan önemli bir halk sağlığı sorunudur. Bu çalışma, hastane mortalitesini etkileyen faktörleri belirlemeyi ve hastane içi kardiyopulmoner arrest geçiren hastalarda entübasyonun sağkalıma katkı sağlayıp sağlamadığını belirlemeyi amaçladı.

Gereç ve Yöntemler: Bu retrospektif, kesitsel çalışma, 1 Ocak 2014 ile 31 Aralık 2018 tarihleri arasında "Mavi Kod" çağrısı olan tüm hastaların olay bildirim formları incelenerek yapılmıştır. Müdahale sonrası ölen ve ölmeyen hastalar yaş, cinsiyet, çağrının yeri, zamanı ve yapılan müdahaleler açısından karşılaştırıldı. Tek
başına kardiyopulmoner resüsitasyon uygulanan hastalar ile kardiyopulmoner resüsitasyon + entübasyon yapılan hastalar hastane içi mortalite açısından karşılaştırıldı; p değerleri <0,05 istatistiksel olarak anlamlı kabul edildi.

Bulgular: Bu çalışmaya toplam 924 hasta dahil edildi. En sık arama %64,4 oranıyla hastanenin servislerinden yapıldı. Hastane içi ölüm oranı %42,4 idi. Hastane içi ölüm oranları yaşlılarda, fazla mesai ve servis çağrılarında, kardiyopulmoner resüsitasyon veya kardiyopulmoner resüsitasyon + entübasyon uygulananlarda anlamlı olarak daha yüksekti. CPR yapılan hastalarda entübasyon sağkalımı etkilemedi. Cinsiyet, yaş, arama zamanı ve müdahale, hastane içi mortalitenin önemli belirleyicileriydi.

Sonuç: Mavi Kod aramaları öncelikle hastane servislerinden mesai saatleri dışında yapılıyordu ve uygunsuz arama oranları yüksekti. Ayrıca yaş, yer ve çağrı zamanı ve müdahaleler hastane içi mortalite için bağımsız risk faktörleriydi; entübasyon, hastane içi kardiyopulmoner arrest geçiren hastalarda sağkalıma katkıda bulunmadı.

Anahtar Kelimeler

Kardiyopulmoner arrest, kardiyopulmoner resüsitasyon, entübasyon, sağkalım, hastane içi mortalite

Kaynakça

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