Adherence to cardiopulmonary resuscitation (CPR) guidelines in treatment of in-hospital cardiac arrest (IHCA) have been associated with favourable patient outcome. The aim of this study was to evaluate if compliance with initial CPR guidelines and patient outcome of witnessed IHCA events were associated with the place of arrest defined as monitored versus non-monitored ward. A total of 956 witnessed IHCA events in adult patients at six hospitals during 2018 to 2019, were extracted from the Swedish Registry of Cardiopulmonary Resuscitation. Initial CPR guidelines were: ≤1 min from collapse to alert of the rapid response team, ≤1 min from collapse to start of CPR, ≤3 min from collapse to defibrillation of shockable rhythm. The odds of compliance with guidelines was higher on monitored wards vs non-monitored wards, even after adjustment for factors that could affect staffing and resources. The place of arrest was not a significant factor for sustained return of spontaneous circulation, survival at 30 days, or neurological status at discharge, when adjusting for clinically relevant confounders. Compliance with initial CPR guidelines remained a significant factor for survival to 30 days and favourable neurological outcome at discharge regardless of other confounders. Compliance with initial CPR guidelines was higher in witnessed IHCA events on monitored wards than on non-monitored wards, which indicates that healthcare professionals in monitored wards are quicker to recognize a cardiac arrest and initiate treatment. When initial CPR guidelines are followed, the place of arrest does not influence patient outcome.

中文翻译：

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在目击的院内心脏骤停事件中遵守心肺复苏指南的情况以及监测病房与非监测病房的患者结果

在治疗院内心脏骤停 (IHCA) 时遵守心肺复苏 (CPR) 指南与良好的患者预后相关。本研究的目的是评估对初始 CPR 指南的遵守情况以及目击 IHCA 事件的患者结果是否与定义为监控病房和非监控病房的逮捕地点相关。从瑞典心肺复苏登记处提取了 2018 年至 2019 年间六家医院总共 956 例目睹的成年患者 IHCA 事件。最初的心肺复苏指导方针是：从倒下到快速反应小组发出警报的时间≤1分钟，从倒下到开始心肺复苏的时间≤1分钟，从倒下到可电击心律除颤的时间≤3分钟。即使在对可能影响人员配置和资源的因素进行调整后，受监控病房遵守指南的几率仍高于非监控病房。在调整临床相关混杂因素时，逮捕地点并不是自主循环持续恢复、30 天生存或出院时神经系统状态的重要因素。无论其他混杂因素如何，遵守最初的心肺复苏指南仍然是存活 30 天和出院时良好神经系统结果的重要因素。监测病房中目睹的 IHCA 事件对初始心肺复苏指南的遵守率高于非监测病房，这表明监测病房的医疗保健专业人员能够更快地识别心脏骤停并开始治疗。当遵循最初的心肺复苏指南时，逮捕地点不会影响患者的治疗结果。