A nationwide overview of 1-year mortality in cardiac arrest patients admitted to intensive care units in the Netherlands between 2010 and 2016

Loes Mandigers; Fabian Termorshuizen; Nicolette F de Keizer; Diederik Gommers; Dinis Dos Reis Miranda; Wim J R Rietdijk; Corstiaan A den Uil

doi:10.1016/j.resuscitation.2019.12.029

A nationwide overview of 1-year mortality in cardiac arrest patients admitted to intensive care units in the Netherlands between 2010 and 2016

Resuscitation. 2020 Feb 1:147:88-94. doi: 10.1016/j.resuscitation.2019.12.029. Epub 2020 Jan 8.

Authors

Loes Mandigers¹, Fabian Termorshuizen², Nicolette F de Keizer², Diederik Gommers³, Dinis Dos Reis Miranda³, Wim J R Rietdijk³, Corstiaan A den Uil⁴

Affiliations

¹ Department of Intensive Care, Erasmus MC University Medical Center, Rotterdam, The Netherlands. Electronic address: l.mandigers@erasmusmc.nl.
² National Intensive Care Evaluation (NICE) Foundation, Amsterdam, The Netherlands; Department of Medical Informatics, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands.
³ Department of Intensive Care, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
⁴ Department of Intensive Care, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

PMID: 31926259
DOI: 10.1016/j.resuscitation.2019.12.029

Abstract

Aim: Worldwide, cardiac arrest (CA) remains a major cause of death. Most post-CA patients are admitted to the intensive care unit (ICU). The aim of this study is to describe mortality rates and possible changes in mortality rates in patients with CA admitted to the ICU in the Netherlands between 2010 and 2016.

Methods: In this study, we included all adult CA patients registered in the National Intensive Care Evaluation (NICE) registry who were admitted to ICUs in the Netherlands between 2010 and 2016. The primary outcome was 1-year mortality which was analysed by Cox regression. The secondary outcomes were ICU mortality and hospital mortality. Hospital mortality was analysed by binary logistic regression analysis. Patients were stratified by whether they experienced in-hospital cardiac arrest (IHCA) or out-of-hospital cardiac arrest (OHCA). Finally, the outcome over calendar time was assessed for both groups.

Results: We included 26,056 CA patients: 10,618 (40.8%) IHCA patients and 14,482 (55.6%) OHCA patients. The 1-year mortality rate was 57.5%: 59% for IHCA and 56.4% for OHCA, p < 0.01. This mortality rate remained stable between 2010 and 2016 for IHCA (p = 0.31) and declined for OHCA patients (p = 0.01). The hospital mortality rate was 50.3%: 50.5% for IHCA and 50.2% for OHCA, p = 0.66. This mortality rate remained stable between 2010-2016 for IHCA (p = 0.21) and decreased for OHCA patients (p < 0.01). An additional analysis with calendar year as a continuous variable showed a mortality decline of 1.56% per calendar year for 1-year mortality.

Conclusion: This nationwide registry cohort study reported a 57.5% 1-year mortality rate for CA patients admitted to the ICU between 2010 and 2016. We reported a decline in 1-year mortality for OHCA patients in these years.

Keywords: 1-year mortality; Cardiac arrest; Heart arrest; ICU; Intensive care units; Mortality.

MeSH terms

Adult
Cardiopulmonary Resuscitation*
Cohort Studies
Humans
Intensive Care Units
Netherlands / epidemiology
Out-of-Hospital Cardiac Arrest* / mortality
Out-of-Hospital Cardiac Arrest* / therapy
Retrospective Studies