1. Outcomes after cardiac arrest in Medical Intensive Care Unit: A propensity score matching analysis of COVID-19 MICU vs non COVID-19 MICU cardiac arrest.
- Author
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Bhardwaj A, Alwakeel M, Kirincich J, Shaheen H, Gaieski DF, Abella BS, Wang X, Al-Jaghbeer MJ, Duggal A, Abi Fadel F, and Krishnan S
- Subjects
- Male, Humans, Middle Aged, Female, Propensity Score, Pandemics, Intensive Care Units, Retrospective Studies, Cardiopulmonary Resuscitation, COVID-19 epidemiology, Heart Arrest
- Abstract
Aim: To assess whether there were differences in resuscitation efforts and outcomes for medical intensive care unit (MICU) in-hospital cardiac arrest (IHCA) during the COVID-19 pandemic when compared to pre-pandemic., Methods: Comparing COVID-19 MICU-IHCA patients (03/2020 to 10/2020) to non-COVID-19 MICU IHCA (01/2014 to 12/2018) at Clevleand Clinic Health System (CCHS) of NE Ohio. Propensity score matching analysis (PSMA) was used to create comparable groups., Results: There were a total of 516 patients, 51 in COVID-19 MICU IHCA cohort and 465 in the non-COVID-19 MICU IHCA cohort. The mean (SD) age of the study population was 60.9 (16) years and 56% were males. In 92.1% (n = 475) patients, initial arrest rhythm was non-shockable. At the time of ICU admission, compared to the non-COVID-19 MICU-IHCA cohort, the COVID-19 MICU IHCA cohort had a lower mean APACHE III score (70 [32.9] vs 101.3 [39.6], P = <0.01). The COVID-19 cohort had a higher rate of survival to hospital discharge (12 [23.5%] vs 59 [12.7%], P = 0.03). Upon PSMA, the algorithm selected 40 COVID-19 patients and 200 non-COVID-19 patients. Imbalances in baseline characteristics, comorbidities, and APACHE III were well-balanced after matching. Survival rate after matching became non-significant; (10 [25%] vs 42 [21%], P = 0.67). Further, there were no significant differences in ICU or hospital length-of-stay or neurological outcomes at discharge for survivors in the two matched cohorts., Conclusion: It is imperative that COVID-19 patients receive unbiased and unrestricted resuscitation measures, without any discouragement., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ‘Co-author Benjamin S. Abella is part of the Resusitation Journal Editorial Board’., (Copyright © 2023 Elsevier B.V. All rights reserved.)
- Published
- 2023
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