ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG, NGUYÊN NHÂN VÀ KẾT CỤC NGƯỜI BỆNH NGƯNG TIM TẠI KHOA CẤP CỨU BỆNH VIỆN ĐẠI HỌC Y DƯỢC THÀNH PHỐ HỒ CHÍ MINH

Abstract

Background: In-hospital cardiac arrest (IHCA) is a critical emergency necessitating a rapid and timely response from the resuscitation team. Emergency department cardiac arrest (EDCA), a subgroup of IHCA, is associated with a lower rate of survival and return of spontaneous circulation (ROSC). Despite its significance, research specifically focusing on EDCA remains limited. Identifying the clinical and paraclinical characteristics, causes, and outcomes of these patients will enhance the understanding of the current state of EDCA and provide valuable clinical data to improve patient management. Objective: To investigate the clinical and paraclinical characteristics, causes, and outcomes of patients with EDCA. Methods: A descriptive, retrospective cross-sectional study was conducted on adult patients (≥18 years old) with non-traumatic EDCA. Results: From December 1st, 2021, to August 30th, 2024, 51 EDCA patients were identified, with a mean age of 67.39 ± 17 years, and males accounted for 72.54%. Dyspnea was the most common symptom reported before cardiac arrest (60.78%). Pre-existing chronic diseases were documented in 84.31% of the patients. Cardiovascular disease was the leading cause of cardiac arrest (37.25%). The ROSC rate was nearly 47%, with 3.9% of patients being discharged in a conscious state. A CPR (Low-flow: LF) duration of 37 minutes, with an AUC of 0,949 (CI 95%: 0,885-1), suggested the best chance of ROSC. Preliminary analysis showed that low-flow time (LF) was associated with ROSC (OR: 0.949 [0.85-0.99], p=0.031). Conclusion: Cardiovascular causes are the leading cause of EDCA, with most NB patients having pre-existing chronic conditions. Survival rates are low. Time to CPR has been shown to have an independent association with the outcome of ROSC. We observed that the first 37 minutes offer the best chance of achieving ROSC therefore the importance of early detection of NT and initiation of CPR in improving outcomes for NB patients. However, common clinical parameters such as blood pH, lactate, liver function, and kidney function were unable to predict ROSC in our study population. Therefore, to gain a more comprehensive understanding, larger-scale studies are needed in the future.