Intensive Care Medicine

, Volume 30, Issue 11, pp 2126–2128 | Cite as

Mode of death after admission to an intensive care unit following cardiac arrest

  • Stephen Laver
  • Catherine Farrow
  • Duncan Turner
  • Jerry Nolan
Brief Report

Abstract

Objective

To determine the mode of death in patients admitted to an intensive care unit (ICU) after cardiac arrest who died before hospital discharge.

Design

Prospectively defined retrospective review of a database and individual patient medical records and ICU charts.

Setting

Eleven-bed multidisciplinary intensive care unit in a general hospital in the United Kingdom.

Patients and participants

All patients admitted to ICU between February 1998 and July 2003 after a cardiac arrest in the previous 24 h.

Measurements and results

The outcome at hospital discharge and mode of death in non-survivors were recorded. Based on the mode of death, non-survivors were placed in one of three groups: multiple organ failure death, neurological death or cardiovascular death. Two hundred and five patients were admitted to ICU after a cardiac arrest; 113 (55.1%) after out-of-hospital cardiac arrest and 92 (44.9%) after in-hospital cardiac arrest. One hundred and twenty-six (61.5%) patients died before hospital discharge and of these 58 (46.0%) died due to neurological injury. After cardiac arrest, 22.9% of the in-hospital patients and 67.7% of the out-of-hospital patients died due to neurological injury, irrespective of the primary cardiac arrest arrhythmia.

Conclusions

Two-thirds of the patients dying after out-of-hospital cardiac arrest died due to neurological injury and this proportion was approximately the same for ventricular fibrillation/ventricular tachycardia and pulseless electrical activity/asystole. Approximately a quarter of the patients dying after in-hospital cardiac arrest died due to neurological injury.

Keywords

Cardiopulmonary resuscitation Mode of death Post resuscitation care 

References

  1. 1.
    Pell JP, Sirel JM, Marsden AK, Ford I, Walker NL, Cobbe SM (2003) Presentation, management and outcome of out of hospital cardiopulmonary arrest: comparison by underlying aetiology. Heart 89:839–842CrossRefPubMedGoogle Scholar
  2. 2.
    Gwinnutt CL, Columb M, Harris R (2000) Outcome after cardiac arrest in adults in UK hospitals: effect of the 1997 guidelines. Resuscitation 47:125–135CrossRefPubMedGoogle Scholar
  3. 3.
    Herlitz J, Bang A, Aune S, Ekstrom L, Lundstrom G, Holmberg S (2001) Characteristics and outcome among patients suffering in-hospital cardiac arrest in monitored and non-monitored areas. Resuscitation 48:125–135CrossRefPubMedGoogle Scholar
  4. 4.
    Safar P, Behringer W, Bottiger BW, Sterz F (2002) Cerebral resuscitation potentials for cardiac arrest. Crit Care Med 30:S140–144CrossRefPubMedGoogle Scholar
  5. 5.
    Bernard GR, Vincent J-L, Laterre P-F et al. (2001) Efficacy and safety of recombinant human activated protein C for severe sepsis N Engl J Med 344:699–709CrossRefPubMedGoogle Scholar
  6. 6.
    Hypothermia After Cardiac Arrest Study Group (2002) Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 346:549–556CrossRefPubMedGoogle Scholar
  7. 7.
    Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, Smith K (2002) Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 346:557–563CrossRefPubMedGoogle Scholar
  8. 8.
    Nolan JP, Morley PT, Hoek TL, Hickey RW (2003) Therapeutic hypothermia after cardiac arrest. An advisory statement by the Advancement Life Support Task Force of the International Liaison Committee on Resuscitation. Resuscitation 57:231–235CrossRefPubMedGoogle Scholar
  9. 9.
    Skogvoll E, Isern E, Sangolt GK, Gisvold SE (1999) In-hospital cardiopulmonary resuscitation. 5 years’ incidence and survival according to the Utstein template. Acta Anaesthesiol Scand 43:177–184CrossRefPubMedGoogle Scholar
  10. 10.
    Polderman KH (2004) Application of therapeutic hypothermia in the intensive care unit. Opportunities and pitfalls of a promising treatment modality—Part 2: Practical aspects and side effects. Intensive Care Med 30:757–769PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Stephen Laver
    • 1
  • Catherine Farrow
    • 1
  • Duncan Turner
    • 1
  • Jerry Nolan
    • 1
  1. 1.Intensive Care UnitRoyal United HospitalBathUK

Personalised recommendations