ASSESSMENT OF SURVIVAL RATE OF IN HOSPITAL CARDIAC ARREST AND ITS ASSOCIATED FACTORS AMONG PATIENTS ADMITTED TO EMERGENCY DEPARTMENT OF SELECTED HOSPITAL, ADDIS ABABA, ETHIOPIA

Abstract

Abstract Background: As defined by the American Heart Association and the American College of Cardiology cardiac arrest is the sudden cessation of cardiac activity so that the victim becomes unresponsive, with no normal breathing and no signs of circulation. Cardiac arrest is typically classified as either out-of-hospital or in-hospital cardiac arrest. According to the Utstein criteria, a cardiac arrest is classified as ‘in-hospital’ if it occurs in a hospitalized patient who had a pulse at the time of admission. Although evidence from out-ofhospital cardiac arrest is frequently extrapolated to in-hospital cardiac arrest, the epidemiology is different, and success determinants may differ accordingly & data on IHCA incidence and survival are scarce. Objectives: To assess the survival rate of in hospital cardiac arrest and its associated factors among patient admitted to Emergency department in SPHMMC, Addis Ababa, Ethiopia; 2023 Methods: A hospital based cross sectional study was conducted to asses survival rate of inhospital cardiac arrest among patients admitted to emergency department of Saint Paul's hospital millennium medical college. Data were collected using a structured questioner from the participant’s medical records ; coded, transferred and analyzed in describitive and analytical software ; SPSS Version-25. Both bivariante and multivariable logistic regression models were used. P-value < 0.05 was considered as statistically significant association. vi Results: The immediate survival rate after CPR was 46.5%. Respiratory failure and hypotension were the most common cause cardiac arrest( 25.12% and 21%) respectively. Having respiratory failure as cause of arrest (AOR: 15.04; 95%CI: 2.34,95.13), ECG monitoring (AOR: 4.94;95% CI: 1.59,15.39), initial rhythm of Ventricular fibrillation and Pulse less v.tachycardia (AOR: 37.93;95% CI: 2.20,655.58 and AOR: 25.64; 95% CI: 5.08,129.47) respectively and Delivery of electric shock during CPR (AOR: 12.09; 95% CI: 4.15,35.21) were statistically significant in multivariable analysis, while majority of patients with sepsis as the cause of admission were less likely to survive as compared with those who had no sepsis during admission(AOR:0.05; 95%CI: .01,.68). Conclusion and recommendations: The immediate survival rate of IHCA was 46.5%. ECG monitor, respiratory failure, initial rhythm of Ventricular fibrillation and Pulse less v.tachycardia, electric shock during CPR, were the independent factors associated with survival rate of patients with IHCA. Patients with sepsis as the cause of admission should trace the essential treatment modalities to minimize the risk of mortality. Structured and standardized resuscitation registration and checklist format should adopted and practiced not only in ED but also in all area of care and the study will used as entry to do it with multicenter bases and in different area of care Keywords: In hospital cardiac arrest, Emergency Department, Ethiopia