In-hospital cardiac arrest in critically ill patients with covid-19: multicenter cohort study
To estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in critically ill adults with coronavirus disease 2019 (covid-19). Multicenter cohort study. Intensive care units at 68 geographically diverse hospitals across the Unite...
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| Published in | BMJ (Online) Vol. 371; p. m3513 |
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| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
BMJ Publishing Group Ltd
30.09.2020
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| Subjects | |
| Online Access | Get full text |
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| Abstract | To estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in critically ill adults with coronavirus disease 2019 (covid-19).
Multicenter cohort study.
Intensive care units at 68 geographically diverse hospitals across the United States.
Critically ill adults (age ≥18 years) with laboratory confirmed covid-19.
In-hospital cardiac arrest within 14 days of admission to an intensive care unit and in-hospital mortality.
Among 5019 critically ill patients with covid-19, 14.0% (701/5019) had in-hospital cardiac arrest, 57.1% (400/701) of whom received cardiopulmonary resuscitation. Patients who had in-hospital cardiac arrest were older (mean age 63 (standard deviation 14)
60 (15) years), had more comorbidities, and were more likely to be admitted to a hospital with a smaller number of intensive care unit beds compared with those who did not have in-hospital cardiac arrest. Patients who received cardiopulmonary resuscitation were younger than those who did not (mean age 61 (standard deviation 14)
67 (14) years). The most common rhythms at the time of cardiopulmonary resuscitation were pulseless electrical activity (49.8%, 199/400) and asystole (23.8%, 95/400). 48 of the 400 patients (12.0%) who received cardiopulmonary resuscitation survived to hospital discharge, and only 7.0% (28/400) survived to hospital discharge with normal or mildly impaired neurological status. Survival to hospital discharge differed by age, with 21.2% (11/52) of patients younger than 45 years surviving compared with 2.9% (1/34) of those aged 80 or older.
Cardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among older patients. |
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| AbstractList | OBJECTIVESTo estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in critically ill adults with coronavirus disease 2019 (covid-19). DESIGNMulticenter cohort study. SETTINGIntensive care units at 68 geographically diverse hospitals across the United States. PARTICIPANTSCritically ill adults (age ≥18 years) with laboratory confirmed covid-19. MAIN OUTCOME MEASURESIn-hospital cardiac arrest within 14 days of admission to an intensive care unit and in-hospital mortality. RESULTSAmong 5019 critically ill patients with covid-19, 14.0% (701/5019) had in-hospital cardiac arrest, 57.1% (400/701) of whom received cardiopulmonary resuscitation. Patients who had in-hospital cardiac arrest were older (mean age 63 (standard deviation 14) v 60 (15) years), had more comorbidities, and were more likely to be admitted to a hospital with a smaller number of intensive care unit beds compared with those who did not have in-hospital cardiac arrest. Patients who received cardiopulmonary resuscitation were younger than those who did not (mean age 61 (standard deviation 14) v 67 (14) years). The most common rhythms at the time of cardiopulmonary resuscitation were pulseless electrical activity (49.8%, 199/400) and asystole (23.8%, 95/400). 48 of the 400 patients (12.0%) who received cardiopulmonary resuscitation survived to hospital discharge, and only 7.0% (28/400) survived to hospital discharge with normal or mildly impaired neurological status. Survival to hospital discharge differed by age, with 21.2% (11/52) of patients younger than 45 years surviving compared with 2.9% (1/34) of those aged 80 or older. CONCLUSIONSCardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among older patients. Abstract Objectives To estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in critically ill adults with coronavirus disease 2019 (covid-19). Design Multicenter cohort study. Setting Intensive care units at 68 geographically diverse hospitals across the United States. Participants Critically ill adults (age ≥18 years) with laboratory confirmed covid-19. Main outcome measures In-hospital cardiac arrest within 14 days of admission to an intensive care unit and in-hospital mortality. Results Among 5019 critically ill patients with covid-19, 14.0% (701/5019) had in-hospital cardiac arrest, 57.1% (400/701) of whom received cardiopulmonary resuscitation. Patients who had in-hospital cardiac arrest were older (mean age 63 (standard deviation 14) v 60 (15) years), had more comorbidities, and were more likely to be admitted to a hospital with a smaller number of intensive care unit beds compared with those who did not have in-hospital cardiac arrest. Patients who received cardiopulmonary resuscitation were younger than those who did not (mean age 61 (standard deviation 14) v 67 (14) years). The most common rhythms at the time of cardiopulmonary resuscitation were pulseless electrical activity (49.8%, 199/400) and asystole (23.8%, 95/400). 48 of the 400 patients (12.0%) who received cardiopulmonary resuscitation survived to hospital discharge, and only 7.0% (28/400) survived to hospital discharge with normal or mildly impaired neurological status. Survival to hospital discharge differed by age, with 21.2% (11/52) of patients younger than 45 years surviving compared with 2.9% (1/34) of those aged 80 or older. Conclusions Cardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among older patients. To estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in critically ill adults with coronavirus disease 2019 (covid-19). Multicenter cohort study. Intensive care units at 68 geographically diverse hospitals across the United States. Critically ill adults (age ≥18 years) with laboratory confirmed covid-19. In-hospital cardiac arrest within 14 days of admission to an intensive care unit and in-hospital mortality. Among 5019 critically ill patients with covid-19, 14.0% (701/5019) had in-hospital cardiac arrest, 57.1% (400/701) of whom received cardiopulmonary resuscitation. Patients who had in-hospital cardiac arrest were older (mean age 63 (standard deviation 14) 60 (15) years), had more comorbidities, and were more likely to be admitted to a hospital with a smaller number of intensive care unit beds compared with those who did not have in-hospital cardiac arrest. Patients who received cardiopulmonary resuscitation were younger than those who did not (mean age 61 (standard deviation 14) 67 (14) years). The most common rhythms at the time of cardiopulmonary resuscitation were pulseless electrical activity (49.8%, 199/400) and asystole (23.8%, 95/400). 48 of the 400 patients (12.0%) who received cardiopulmonary resuscitation survived to hospital discharge, and only 7.0% (28/400) survived to hospital discharge with normal or mildly impaired neurological status. Survival to hospital discharge differed by age, with 21.2% (11/52) of patients younger than 45 years surviving compared with 2.9% (1/34) of those aged 80 or older. Cardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among older patients. |
| Author | Meloche, Chelsea Nallamothu, Brahmajee K Azam, Tariq U Pan, Michael Feroz, Rafey Charytan, David M Melamed, Michal L Perry, Daniel Mallappallil, Mary O'Hayer, Patrick Blakely, Pennelope Hayek, Salim S Anderson, Elizabeth Kaakati, Rayan Bansal, Anip Bitar, Abbas Sunderram, Jag Berlin, Hanna Gupta, Shruti Mathews, Kusum S Shadid, Husam R Leaf, David E Shaefi, Shahzad Shehata, Alexandre M Brenner, Samantha K Srivastava, Anand Sutherland, Anne K Padalia, Kishan |
| Author_xml | – sequence: 1 givenname: Salim S orcidid: 0000-0003-0180-349X surname: Hayek fullname: Hayek, Salim S email: shayek@med.umich.edu organization: Division of Cardiology, Department of Medicine, University of Michigan, Frankel Cardiovascular Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA shayek@med.umich.edu – sequence: 2 givenname: Samantha K surname: Brenner fullname: Brenner, Samantha K organization: Department of Internal Medicine, Heart and Vascular Hospital, Hackensack Meridian Health Hackensack University Medical Center, Hackensack, NJ, USA – sequence: 3 givenname: Tariq U surname: Azam fullname: Azam, Tariq U organization: Division of Cardiology, Department of Medicine, University of Michigan, Frankel Cardiovascular Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA – sequence: 4 givenname: Husam R surname: Shadid fullname: Shadid, Husam R organization: Department of Medicine, University of Michigan, Ann Arbor, MI, USA – sequence: 5 givenname: Elizabeth surname: Anderson fullname: Anderson, Elizabeth organization: Division of Cardiology, Department of Medicine, University of Michigan, Frankel Cardiovascular Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA – sequence: 6 givenname: Hanna surname: Berlin fullname: Berlin, Hanna organization: Department of Medicine, University of Michigan, Ann Arbor, MI, USA – sequence: 7 givenname: Michael surname: Pan fullname: Pan, Michael organization: Department of Medicine, University of Michigan, Ann Arbor, MI, USA – sequence: 8 givenname: Chelsea surname: Meloche fullname: Meloche, Chelsea organization: Department of Medicine, University of Michigan, Ann Arbor, MI, USA – sequence: 9 givenname: Rafey surname: Feroz fullname: Feroz, Rafey organization: Department of Medicine, University of Michigan, Ann Arbor, MI, USA – sequence: 10 givenname: Patrick surname: O'Hayer fullname: O'Hayer, Patrick organization: Department of Medicine, University of Michigan, Ann Arbor, MI, USA – sequence: 11 givenname: Rayan surname: Kaakati fullname: Kaakati, Rayan organization: Department of Medicine, University of Michigan, Ann Arbor, MI, USA – sequence: 12 givenname: Abbas surname: Bitar fullname: Bitar, Abbas organization: Division of Cardiology, Department of Medicine, University of Michigan, Frankel Cardiovascular Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA – sequence: 13 givenname: Kishan surname: Padalia fullname: Padalia, Kishan organization: Department of Medicine, University of Michigan, Ann Arbor, MI, USA – sequence: 14 givenname: Daniel surname: Perry fullname: Perry, Daniel organization: Division of Cardiology, Department of Medicine, University of Michigan, Frankel Cardiovascular Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA – sequence: 15 givenname: Pennelope surname: Blakely fullname: Blakely, Pennelope organization: Division of Cardiology, Department of Medicine, University of Michigan, Frankel Cardiovascular Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA – sequence: 16 givenname: Shruti surname: Gupta fullname: Gupta, Shruti organization: Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA, USA – sequence: 17 givenname: Shahzad surname: Shaefi fullname: Shaefi, Shahzad organization: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA – sequence: 18 givenname: Anand surname: Srivastava fullname: Srivastava, Anand organization: Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL, USA – sequence: 19 givenname: David M surname: Charytan fullname: Charytan, David M organization: Division of Nephrology, New York University Grossman School of Medicine, New York, NY, USA – sequence: 20 givenname: Anip surname: Bansal fullname: Bansal, Anip organization: Division of Renal Diseases and Hypertension, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA – sequence: 21 givenname: Mary surname: Mallappallil fullname: Mallappallil, Mary organization: Division of Nephrology, Department of Internal Medicine, NYC Health + Hospitals Kings County Hospital Center, Brooklyn, NY, USA – sequence: 22 givenname: Michal L surname: Melamed fullname: Melamed, Michal L organization: Division of Nephrology, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA – sequence: 23 givenname: Alexandre M surname: Shehata fullname: Shehata, Alexandre M organization: Hackensack Meridian Health Mountainside Medical Center, Glen Ridge, NJ, USA – sequence: 24 givenname: Jag surname: Sunderram fullname: Sunderram, Jag organization: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA – sequence: 25 givenname: Kusum S surname: Mathews fullname: Mathews, Kusum S organization: Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA – sequence: 26 givenname: Anne K surname: Sutherland fullname: Sutherland, Anne K organization: Division of Pulmonary and Critical Care Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA – sequence: 27 givenname: Brahmajee K surname: Nallamothu fullname: Nallamothu, Brahmajee K organization: Division of Cardiology, Department of Medicine, University of Michigan, Frankel Cardiovascular Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA – sequence: 28 givenname: David E surname: Leaf fullname: Leaf, David E organization: Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32998872$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Contributor | Schenck, Edward J Au, Elizabeth H Saha, Aparna Williams, Aquino Leonberg-Yoo, Amanda K Martinez, Carlos Green, Adam Anderson, Elizabeth Friedman, Allon N Hodakowski, Alexander J Weiner, Daniel E Zhu, Denzel Faugno, Anthony J Hall, Danyell Nadkarni, Girish N Ahoubim, Afshin Danek, Barbara A Mosher, Christopher L Edmonston, Daniel L Srivastava, Anand Shah, Chintan V Jacobs, Alanna L Mehta, Bijal Pannu, Ameeka Oyintayo, Ajiboye Vissing, Andrew Bansal, Amar D Newman, Erik T Sirganagari, Dheeraj Reddy Chang, Emily H Brown, Brent R Judd, Eric Finkel, Diana G Admon, Andrew J Joy, Christina Mariyam Renaghan, Amanda D Azhar, Ambreen Corona-Villalobos, Celia P Burnham, Ellen L Gallagher, Emily J Parikh, Chirag R Kapoor, Aromma Madhani-Lovely, Farah Macedo, Etienne Macina, Ashley Pan, Di Wu, Benjamin Athreya, Akshay Katz-Greenberg, Goni Rashidi, Arash Cervantes, Carmen Elena Zonies, David Vasquez, Charles R Tolwani, Ashita Bitar, Abbas Schorr, Christa A Walther, Carl P Altman, Deena R Kim, Ethan C Modersitzki, Frank Bambrick-Santoyo, Gabriela Zhou, Amy M Vi |
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| Copyright | Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2020 BMJ |
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| References | 33148616 - BMJ. 2020 Nov 4;371:m4250 2020093021301228000_371.sep30_2.m3513.18 2020093021301228000_371.sep30_2.m3513.17 2020093021301228000_371.sep30_2.m3513.10 2020093021301228000_371.sep30_2.m3513.1 2020093021301228000_371.sep30_2.m3513.12 2020093021301228000_371.sep30_2.m3513.11 2020093021301228000_371.sep30_2.m3513.14 2020093021301228000_371.sep30_2.m3513.13 2020093021301228000_371.sep30_2.m3513.16 2020093021301228000_371.sep30_2.m3513.15 2020093021301228000_371.sep30_2.m3513.8 2020093021301228000_371.sep30_2.m3513.9 2020093021301228000_371.sep30_2.m3513.6 2020093021301228000_371.sep30_2.m3513.7 2020093021301228000_371.sep30_2.m3513.4 2020093021301228000_371.sep30_2.m3513.5 2020093021301228000_371.sep30_2.m3513.2 2020093021301228000_371.sep30_2.m3513.3 |
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| Snippet | To estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in critically ill adults... Abstract Objectives To estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in... OBJECTIVESTo estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in critically ill... |
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| SubjectTerms | Adult Aged Aged, 80 and over Betacoronavirus Cohort Studies Coronavirus Infections - complications Coronavirus Infections - mortality Coronavirus Infections - virology COVID-19 Female Heart Arrest - mortality Heart Arrest - virology Hospital Mortality Humans Intensive Care Units - statistics & numerical data Male Middle Aged Pandemics Pneumonia, Viral - complications Pneumonia, Viral - mortality Pneumonia, Viral - virology SARS-CoV-2 United States - epidemiology |
| Title | In-hospital cardiac arrest in critically ill patients with covid-19: multicenter cohort study |
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