TY - JOUR T1 - Clinical outcomes of witnessed and monitored cases of in-hospital cardiac arrest in the general ward of a university hospital in Korea JF - Respiratory Care DO - 10.4187/respcare.02448 SP - respcare.02448 AU - Gyu Rak Chon AU - Jinmi Lee AU - Yujung Shin AU - Jin Won Huh AU - Chae-Man Lim AU - Younsuck Koh AU - Sang-Bum Hong Y1 - 2013/04/22 UR - http://rc.rcjournal.com/content/early/2013/04/23/respcare.02448.abstract N2 - Background: To investigate the clinical outcomes of witnessed and/or monitored cases of in-hospital cardiac arrest (IHCA) that occurred on the general ward of a university hospital in Korea. Methods: We prospectively gathered data on all IHCA events that occurred on the general ward of the Asan Medical Center (Seoul, South Korea) and were recorded by medical emergency team records between March 2008 and February 2010. The main outcomes included survival to hospital discharge, incidence of IHCA, and prognostic factors related to hospital mortality. In addition, we also investigated preventable cases. Results: In total, 238 index cases of IHCA were identified. The average estimated incidence of IHCA was 0.145 events per 1000 patient admissions. Survival to hospital discharge was 19% (46 cases). Of these IHCA cases, 66% were due to non-cardiac causes, and 77% were due to medical illnesses. Besides the most common first documented rhythm was pulseless electrical activity (38%). Two hundred and three cases (85.3%) of IHCA were witnessed at the event; 135 cases (56.7%) were monitored at the event. Non-witnessed cases, monitored cases, night onset, medical illness, metastatic cancer, intubation, and long duration of cardiopulmonary resuscitation were significantly associated with hospital mortality according to logistic regression model. We identified 91 preventable cases (38%) in this study. Respiratory insufficiency (37 cases; 41%) was one of major causes of preventable cases. Conclusions: Witnessed cases of IHCA that occur on the general ward demonstrate a higher rate of survival to hospital discharge; however, monitored cases demonstrate a lower rate of survival to hospital discharge. Respiratory insufficiency was a major preventable cause leading to cardiac arrest. In consideration of the preventable cases of IHCA, further studies should be performed on the monitoring practices that are implemented on general wards. ER -