Independent Risk Factors for Sepsis-Associated Cardiac Arrest in Patients with Septic Shock

Won Soek Yang, Youn-Jung Kim, Seung Mok Ryoo and Won Young Kim
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Won Soek Yang: Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 24252, Korea
Youn-Jung Kim: Asan Medical Center, Department of Emergency Medicine, University of Ulsan College of Medicine, Seoul 44610, Korea
Seung Mok Ryoo: Asan Medical Center, Department of Emergency Medicine, University of Ulsan College of Medicine, Seoul 44610, Korea
Won Young Kim: Asan Medical Center, Department of Emergency Medicine, University of Ulsan College of Medicine, Seoul 44610, Korea

IJERPH, 2021, vol. 18, issue 9, 1-9

Abstract: The clinical characteristics and laboratory values of patients with septic shock who experience in-hospital cardiac arrest (IHCA) have not been well studied. This study aimed to evaluate the prevalence of IHCA after admission into the emergency department and to identify the factors that increase the risk of IHCA in septic shock patients. This observational cohort study used a prospective registry of septic shock patients and was conducted at the emergency department of a university-affiliated hospital. The data of 887 adult (age ? 18 years) septic shock (defined using the Sepsis-3 criteria) patients who were treated with a protocol-driven resuscitation bundle therapy and were admitted to the intensive care unit between January 2010 and September 2018 were analyzed. The primary endpoint was the occurrence of sepsis-associated cardiac arrest. The patient mean age was 65 years, and 61.8% were men. Sepsis-associated cardiac arrest occurred in 25.3% of patients ( n = 224). The 28-day survival rate after cardiac arrest was 6.7%. Multivariate logistic regression identified chronic pulmonary disease (odds ratio (OR) 2.06), hypertension (OR 0.48), unknown infection source (OR 1.82), a hepatobiliary infection source (OR 0.25), C-reactive protein (OR 1.03), and serum lactate level 6 h from shock (OR 1.34). Considering the high mortality rate of sepsis-associated cardiac arrest after cardiopulmonary resuscitation, appropriate monitoring is required in septic shock patients with major risk factors for IHCA.

Keywords: sepsis; septic shock; cardiac arrest; mortality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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