What are the short- and long-term survival outcomes following cardiopulmonary resuscitation for cardiac arrest complicating acute myocardial infarction in an integrated acute medical admission unit?
Survival after cardiac arrest in an integrated acute medical admission unit was lower than typically reported from dedicated CCUs, with only 9% surviving to discharge.
Abstract. During a 38‐month period 1108 cases of acute myocardial infarction have been treated in three medical departments with a joint acute medical admission section containing a coronary care unit (CCU); 285 of them had cardiac arrest (26%). In 209 cases (73% of cardiac arrests) resuscitation was attempted, in 66 cases (23 %) with primary success. Twenty‐five patients (9 %) could be discharged from hospital. Two to four years later 17 were still alive, 14 in heart function class I, 12 with unchanged working ability. Cardiopulmonary resuscitation later than 24 hours after admission to the CCU improved the rate of survival after myocardial infarction by less than 0.5%. In this study the survival after cardiac arrest is somewhat lower than usually reported from CCUs. This is supposed to be due to our treatment of a less selected patient group, and possibly to the untraditional integration of a CCU in an acute medical admission unit. This may lead to a less intensive treatment of the cardiac patients, while it is considered an advantage for the non‐cardiac acute medical patients.
Fabricius-Bjerre et al. (Sat,) studied this question.