Key result
Cardiopulmonary resuscitation for witnessed in-hospital cardiac arrest at a tertiary ED in Malawi achieved immediate return of spontaneous circulation in 11.1% of patients (9/81).
Why the study?
Evidence on adult in-hospital cardiac arrest and cardiopulmonary resuscitation outcomes in low- and middle-income countries, particularly in Sub-Saharan Africa, remains extremely scarce.
Cross-Sectional (n=81)
No
Answers are grounded in this paper and cite their sources.
In-hospital cardiac arrest in a tertiary Malawian emergency department predominantly affects young patients with non-cardiac causes (such as sepsis and trauma) and non-shockable rhythms, resulting in a low immediate ROSC rate of 11.1%.
Background Evidence on adult in-hospital cardiac arrest and cardiopulmonary resuscitation (CPR) outcomes in low- and middle-income countries, particularly in Sub-Saharan Africa, remains extremely scarce. This study aims to describe the baseline patient demographic profiles, clinical characteristics, resuscitation interventions, and immediate Return of Spontaneous Circulation (ROSC) outcomes of patients undergoing CPR at a tertiary Emergency Department in Malawi. Methods This was a prospective, descriptive, cross-sectional study of adult patients (aged 16 years or older) who experienced witnessed cardiac arrest and received CPR in the Adult Emergency and Trauma Centre (AETC) at Queen Elizabeth Central Hospital (QECH) between 11 October 2024 and 11 April 2025. Data were gathered using standardized clinical records, cleaned with Python, and analyzed using descriptive statistics, Fisher's exact test, and the Mann-Whitney U test. Results A total of 81 unique patients were analyzed. The cohort was young (median age: 39 years; IQR: 25.0-52.8) and predominantly male (61.7%). Sepsis or acute infection was the leading diagnostic category (28.4%), followed by trauma or severe hemorrhage (21.0%). Rhythms were overwhelmingly non-shockable (96.3%), primarily pulseless electrical activity (PEA, 67.9%). Only 3.7% presented with shockable rhythms. Adrenaline was administered to 98.8% of patients. Immediate ROSC was achieved in 9 patients (11.1%), of whom 7 (8.6% of the total cohort) were successfully transferred to the Intensive Care Unit (ICU); 2 patients suffered recurrent arrest during post-resuscitation stabilization. Bivariate analysis revealed no statistically significant association between explored demographic or clinical factors and ROSC. Conclusion In-hospital cardiac arrest at QECH primarily affects a young patient population presenting with non-cardiac pathology and non-shockable rhythms. Immediate ROSC rates are low. Standardizing resuscitation documentation and establishing a longitudinal registry are critical next steps to optimize emergency and post-resuscitation care in this setting.
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Humphry Chisambiro (2026) conducted a cross-sectional in In-hospital cardiac arrest (n=81). Cardiopulmonary resuscitation (CPR) was evaluated on Immediate Return of Spontaneous Circulation (ROSC). Cardiopulmonary resuscitation for witnessed in-hospital cardiac arrest at a tertiary ED in Malawi achieved immediate return of spontaneous circulation in 11.1% of patients (9/81).
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