Resuscitation
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Multicenter Study
Variability in survival after in-hospital cardiac arrest depending on the hospital level of care.
Survival after in-hospital cardiac arrest (IHCA) differs considerably between hospitals. This study tries to determine whether this difference is due to patient selection because of the hospital level of care or to effective resuscitation management. ⋯ The comparison of survival following IHCA between different hospitals is difficult, there seems to be undefined factors greatly associated with outcome. A great variability in survival within different hospital areas probably because of differences in patient selection, patient surveillance and resuscitation management was also noted. A locally implemented strong in-hospital chain of survival is probably the only way to improve outcome following IHCA.
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To evaluate the ability of pre-defined clinical criteria to identify patients who subsequently suffer cardiac arrest, unplanned intensive care unit admission or unexpected death; to determine the ability of modified criteria to identify these patients. ⋯ In combination, the respiratory rate, heart rate, systolic blood pressure, and level of consciousness identify patients at risk of cardiac arrest, unplanned intensive care admission or unexpected death with high specificity; however the sensitivity and positive predictive value are relatively low, even after modification of the activation criteria cut-off values.