Background

Approximately 2,500 in-hospital cardiac arrest (IHCA) events are reported annually to the Swedish Registry of Cardiopulmonary Resuscitation (SRCR) with an estimated incidence of 1.7/1,000 hospital admissions. The aim of this study was to evaluate the compliance in reporting IHCA events to the SRCR and to compare reported IHCA events with possible non-reported events, and to estimate IHCA incidence.

Methods

Fifteen diagnose codes, eight Classification of Care Measure codes, and two perioperative complication codes were used to find all treated IHCAs in 2018–2019 at six hospitals of varying sizes and resources. All identified IHCA events were cross-checked against the SRCR using personal identity numbers. All non-reported IHCA events were retrospectively reported and compared with the prospectively reported events.

Results

A total of 3,638 hospital medical records were reviewed and 1,109 IHCA events in 999 patients were identified, with 254 of the events not found in the SRCR. The case completeness was 77% (range 55–94%). IHCA incidence was 2.9/1,000 hospital admissions and 12.4/1,000 admissions to intensive care units. The retrospectively reported events were more often found on monitored wards, involved patients who were younger, had less comorbidity, were often found in shockable rhythm and more often achieved sustained spontaneous circulation, compared with in prospectively reported events.

Conclusion

IHCA case completeness in the SRCR was 77% and IHCA incidence was 2.9/1,000 hospital admissions. The retrospectively reported IHCA events were found in monitored areas where the rapid response team was not alerted, which might have affected regular reporting procedures.

中文翻译：

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国家质量登记处治疗的院内心脏骤停事件的发生率和病例确定——报告和未报告事件的比较

背景

每年向瑞典心肺复苏登记处 (SRCR) 报告约 2,500 起院内心脏骤停 (IHCA) 事件，估计发生率为 1.7/1,000 例住院患者。本研究的目的是评估向 SRCR 报告 IHCA 事件的合规性，并将报告的 IHCA 事件与可能的未报告事件进行比较，并估计 IHCA 发生率。

方法

使用 15 个诊断代码、8 个护理措施分类代码和 2 个围手术期并发症代码来查找 6 家不同规模和资源的医院 2018 年至 2019 年所有接受治疗的 IHCA。所有已识别的 IHCA 事件均使用个人身份号码与 SRCR 进行交叉核对。所有未报告的 IHCA 事件均进行回顾性报告，并与前瞻性报告的事件进行比较。

结果

共审查了 3,638 份医院病历，确定了 999 名患者的 1,109 起 IHCA 事件，其中 254 起事件在 SRCR 中未发现。案例完整性为 77%（范围 55-94%）。IHCA 的发生率为 2.9/1,000 例住院患者和 12.4/1,000 例重症监护病房患者。与前瞻性报告的事件相比，回顾性报告的事件更常见于监测病房，涉及的患者年龄较小，合并症较少，经常发现可电击节律，并且更经常实现持续的自主循环。

结论

SRCR 中的 IHCA 病例完整性为 77%，IHCA 发生率为 2.9/1,000 例住院患者。回顾性报告的 IHCA 事件是在快速反应小组未收到警报的监测区域中发现的，这可能影响了常规报告程序。