Incidence of in-hospital cardiac arrest at general wards before and after implementation of an early warning score
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Incidence of in-hospital cardiac arrest at general wards before and after implementation of an early warning score. / Creutzburg, Andreas; Isbye, Dan; Rasmussen, Lars S.
I: BMC Emergency Medicine, Bind 21, Nr. 1, 79, 2021.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Incidence of in-hospital cardiac arrest at general wards before and after implementation of an early warning score
AU - Creutzburg, Andreas
AU - Isbye, Dan
AU - Rasmussen, Lars S.
N1 - Publisher Copyright: © 2021, The Author(s).
PY - 2021
Y1 - 2021
N2 - Background: In order to reduce the incidence of in-hospital cardiac arrest (IHCA) at general wards, medical emergency teams (MET) were implemented in the Capital Region of Denmark in 2012 as the efferent part of a track and trigger system. The National Early Warning Score (NEWS) system became the afferent part. This study aims at investigating the incidence of IHCA at general wards before and after the implementation of the NEWS system. Material and methods: We included patients at least 18 years old with IHCA at general wards in our hospital in the periods of 2006 to 2011 (pre-EWS group) and 2013 to 2018 (post-EWS group). Data was obtained from a local database and the National In-Hospital Cardiac Arrest Registry (DANARREST). We calculated incidence rate ratios (IRR) for IHCA at general wards with 95% confidence interval (95% CI). Odds ratios (OR) for return of spontaneous circulation (ROSC) and 30-day survival were also calculated with 95% CI. Results: A total of 444 IHCA occurred before the implementation of NEWS at general wards while 494 IHCA happened afterwards. The incidence rate of IHCA at general wards was 1.13 IHCA per 1000 admissions in the pre-EWS group (2006–2011) and 1.11 IHCA per 1000 admissions in the post-EWS group (2013–2018). The IRR between the two groups was 0.98 (95% CI [0.86;1.11], p = 0.71). The implementation did not affect the chance of ROSC with a crude OR of 1.14 (95% CI [0.88;1.47], p = 0.32) nor did it change the 30-day survival with a crude OR 1.30 (95% CI [0.96;1.75], p = 0.09). Conclusion: Implementation of the EWS system at our hospital did not decrease the incidence rate of in-hospital cardiac arrest at general wards.
AB - Background: In order to reduce the incidence of in-hospital cardiac arrest (IHCA) at general wards, medical emergency teams (MET) were implemented in the Capital Region of Denmark in 2012 as the efferent part of a track and trigger system. The National Early Warning Score (NEWS) system became the afferent part. This study aims at investigating the incidence of IHCA at general wards before and after the implementation of the NEWS system. Material and methods: We included patients at least 18 years old with IHCA at general wards in our hospital in the periods of 2006 to 2011 (pre-EWS group) and 2013 to 2018 (post-EWS group). Data was obtained from a local database and the National In-Hospital Cardiac Arrest Registry (DANARREST). We calculated incidence rate ratios (IRR) for IHCA at general wards with 95% confidence interval (95% CI). Odds ratios (OR) for return of spontaneous circulation (ROSC) and 30-day survival were also calculated with 95% CI. Results: A total of 444 IHCA occurred before the implementation of NEWS at general wards while 494 IHCA happened afterwards. The incidence rate of IHCA at general wards was 1.13 IHCA per 1000 admissions in the pre-EWS group (2006–2011) and 1.11 IHCA per 1000 admissions in the post-EWS group (2013–2018). The IRR between the two groups was 0.98 (95% CI [0.86;1.11], p = 0.71). The implementation did not affect the chance of ROSC with a crude OR of 1.14 (95% CI [0.88;1.47], p = 0.32) nor did it change the 30-day survival with a crude OR 1.30 (95% CI [0.96;1.75], p = 0.09). Conclusion: Implementation of the EWS system at our hospital did not decrease the incidence rate of in-hospital cardiac arrest at general wards.
KW - Early warning score
KW - General wards
KW - In-hospital cardiac arrest
KW - Incidence
U2 - 10.1186/s12873-021-00469-5
DO - 10.1186/s12873-021-00469-5
M3 - Journal article
C2 - 34233624
AN - SCOPUS:85109782279
VL - 21
JO - BMC Emergency Medicine
JF - BMC Emergency Medicine
SN - 1471-227X
IS - 1
M1 - 79
ER -
ID: 275014635