The epidemiology of cardiac arrests in a Sydney hospital

Aim: To examine the epidemiology of cardiac arrest (CA) in New South Wales (NSW), Australia, and a large teaching hospital in Sydney and to identify predictors of survival. Methods: Data from the 1996/97 NSW inpatient statistics collection were analysed. Logistic regression was used to determine predictors of mortality from CA. Results: In 1996/97 in public hospitals, Eastern Sydney Area Health Service (AHS) (47.5), and in private hospitals of Macleay-Hastings District Health Services (DHSs), recorded the highest crude CA rates in NSW with figures of 47.5 and 21.3 per 10,000 hospital separations. Standardised CA rates were highest in Western Sydney, Illawara, Macleay-Hasting, Mid North Coast and Orana DHSs. Most CAs in hospital 'X' occurred after admission and 55.7% occurred in patients admitted with a non-cardiac principal diagnosis, mainly pneumonia. Acute myocardial infarction was the leading diagnosis (28.9%) in patients who suffered CA after admission. Only 32% of CA patients survived to discharge. Age above 65 (odds ratio (OR)=2.284, P=0.006) had the highest effect on cardiac mortality. The longer the patients were in the intensive care unit (OR=0.997, P=0.037), the more likely they were to survive. Conclusion: We describe considerable variation in CA rates in NSW. The majority of hospital CAs occur at or soon after admission, and are associated with underlying non-cardiac conditions. Survival following hospital CA is low, but there may be preventable elements. Knowledge of risk factors and epidemiology of hospital CAs may help identify patients at risk of CA.