Polypharmacy prior to in-hospital cardiac arrest among patients with cardiopulmonary diseases: A pilot study.
In-hospital cardiac arrest
Initial Rhythms of Cardiac Arrest
Polypharmacy
Survival
Journal
Resuscitation plus
ISSN: 2666-5204
Titre abrégé: Resusc Plus
Pays: Netherlands
ID NLM: 101774410
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
entrez:
10
5
2021
pubmed:
11
5
2021
medline:
11
5
2021
Statut:
ppublish
Résumé
Patterns of medication administration prior to in-hospital cardiac arrest (I-HCA) and the potential impact of these on patient outcomes is not well-established. Accordingly, types of medications administered in the 72 h prior to I-HCA were examined in relation to initial rhythms of I-HCA and survival. A retrospective, pilot study was conducted among 96 patients who experienced I-HCA. Clinical characteristics and treatments including medications were extracted from electronic health records. Relative risk (RR) of medications or class of medications associated with the initial rhythms of I-HCA and return of spontaneous circulation (ROSC) were calculated. Two distinct sub-groups were identified that did not survive to hospital discharge (n = 31): 1) those who received either vasopressin/desmopressin (n = 16) and 2) those who received combinations of psychotherapeutic agents with anxiolytics, sedatives, and hypnotics (n = 15) prior to I-HCA. The risk of pulseless electrical activity and asystolic arrest was high in patients who received sympathomimetic agents alone or in combination with β-Adrenergic blocking agents, (RR = 1.40, 1.41, respectively). Vasopressin and a combination of vasopressin and fentanyl were associated with risk of unsuccessful ROSC (RR = 2.50, 2.38, respectively). The types of medications administered during inpatient care may serve as a surrogate marker for identifying patients at risk of specific initial rhythms of I-HCA and survival.
Sections du résumé
BACKGROUND
BACKGROUND
Patterns of medication administration prior to in-hospital cardiac arrest (I-HCA) and the potential impact of these on patient outcomes is not well-established. Accordingly, types of medications administered in the 72 h prior to I-HCA were examined in relation to initial rhythms of I-HCA and survival.
METHODS
METHODS
A retrospective, pilot study was conducted among 96 patients who experienced I-HCA. Clinical characteristics and treatments including medications were extracted from electronic health records. Relative risk (RR) of medications or class of medications associated with the initial rhythms of I-HCA and return of spontaneous circulation (ROSC) were calculated.
RESULTS
RESULTS
Two distinct sub-groups were identified that did not survive to hospital discharge (n = 31): 1) those who received either vasopressin/desmopressin (n = 16) and 2) those who received combinations of psychotherapeutic agents with anxiolytics, sedatives, and hypnotics (n = 15) prior to I-HCA. The risk of pulseless electrical activity and asystolic arrest was high in patients who received sympathomimetic agents alone or in combination with β-Adrenergic blocking agents, (RR = 1.40, 1.41, respectively). Vasopressin and a combination of vasopressin and fentanyl were associated with risk of unsuccessful ROSC (RR = 2.50, 2.38, respectively).
CONCLUSIONS
CONCLUSIONS
The types of medications administered during inpatient care may serve as a surrogate marker for identifying patients at risk of specific initial rhythms of I-HCA and survival.
Identifiants
pubmed: 33969325
doi: 10.1016/j.resplu.2020.100026
pmc: PMC8104360
mid: NIHMS1691259
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : NCATS NIH HHS
ID : TL1 TR000096
Pays : United States
Organisme : NCATS NIH HHS
ID : TL1 TR002000
Pays : United States
Organisme : NIMHD NIH HHS
ID : U54 MD012397
Pays : United States
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare that they have no conflicts of interests.
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