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VOLUME 27 , ISSUE 5 ( May, 2023 ) > List of Articles

Original Article

Arrest Outcome Consortium Registry Analysis [AOCRA 2022]: Outcome Statistics of Cardiac Arrest in Tertiary Care Hospitals in India, Analysis of Five Year Data of Indian Online Cardiac Arrest Registry,

Krunalkumar Patel, Bhagyesh Ashwinkumar Shah, Dhavalkumar Prajapati, Ritesh Jayantkumar Shah, Jasmin Rachhadia, Bhavin Vyas

Keywords : Cardiac arrest, Cardiopulmonary resuscitation, In-hospital cardiac arrest, Online registry, Out-of-hospital cardiac arrest, Restoration of spontaneous circulation, Survival to discharge

Citation Information : Patel K, Shah BA, Prajapati D, Shah RJ, Rachhadia J, Vyas B. Arrest Outcome Consortium Registry Analysis [AOCRA 2022]: Outcome Statistics of Cardiac Arrest in Tertiary Care Hospitals in India, Analysis of Five Year Data of Indian Online Cardiac Arrest Registry, Indian J Crit Care Med 2023; 27 (5):322-329.

DOI: 10.5005/jp-journals-10071-24457

License: CC BY-NC 4.0

Published Online: 29-04-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim and background: To publish data with outcome statistics from our online cardiac arrest (CA) outcome consortium (AOC) online registry. Materials and methods: Data on cardiac arrest (CA) from tertiary care hospitals were collected on the AOC registry online portal from January 2017 to May 2022. Survival endpoints from cardiac arrest events like ROSC, and survival at hospital discharge with neurological status at discharge were analyzed and presented. Studies of demographics, the association of outcome with age, gender, bystander CPR, low and no flow times, and admission lactate were also done along with suitable statistical analysis. Results: Out of 2,235 CA, 2,121 received CPR (1,998 IHCA, 123 Out of hospital Cardiac Arrest (OHCA)) as 114 were DNR. The males-female ratio was 70:30. Average age at arrest was 58.7 years. 26% OHCA received bystander CPR but survival advantage was not significant. (with 16%, without 14% p = 0.78). Asystole (67.7%), Pulseless Electrical Activity (PEA) (25.6%), and VF/pVT (6.7%) as first rhythm significantly influence survival (4.9, 8.6 and 39.4%: p < 0.001) ROSC was achieved in 355 (16.7%), with 173 (8.2%) alive and 141 (6.6%) having good (CPC ≤ 2) neurological state at discharge. At discharge, survival as well as CPC ≤ 2 outcomes were significantly better in females. On multivariate regression analysis, first rhythm and low flow time influence survival at discharge. Admission lactate (available only in 102 OHCA) was lower in survivors than non-survivors 10.3 vs 11.5 mmol/L but the difference was not statistically significant (p = 0.397]. Conclusion: Data from our AOC registry shows poor overall survival from CA. The Female gender had a higher survival rate. Ventricular Fibrillation/Pulseless Ventricular Tachycardia (VF/pVT) as first rhythm and low flow time influence the survival to discharge (CTRI/2022/11/047140).

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  1. Deo R, Albert CM. Epidemiology and genetics of sudden cardiac death. Circulation 2012;125(4):620–637. DOI: 10.1161/CIRCULATIONAHA.111.023838.
  2. Larsen MP, Eisenberg MS, Cummins RO, Hallstrom AP. Predicting survival from out-of-hospital cardiac arrest: A graphic model. Ann Emerg Med 1993;22(11):1652–1658. DOI: 10.1016/s0196-0644(05)81302-2.
  3. Valenzuela TD, Roe DJ, Cretin S, Spaite DW, Larsen MP. Estimating effectiveness of cardiac arrest interventions: a logistic regression survival model. Circulation 1997;96(10):3308–3313. DOI: 10.1161/01.cir.96.10.3308.
  4. Holmberg M, Holmberg S, Herlitz J, Swedish Cardiac Arrest Registry. Factors modifying the effect of bystander cardiopulmonary resuscitation on survival in out-of-hospital cardiac arrest patients in Sweden. Eur Heart J 2001;22(6):511–519. DOI: 10.1053/euhj.2000.2421.
  5. Holmberg M, Holmberg S, Herlitz J, Gårdelöv B, Swedish Cardiac Arrest Registry. Survival after cardiac arrest outside hospital in Sweden. Swedish Cardiac Arrest Registry. Resuscitation 1998;36(1):29–36. DOI: 10.1016/s0300-9572(97)00089-0.
  6. Bajan KB, Raje K, Hegde A, Kapadia F. In hospital cardiopulmonary resuscitation: A one year study. J Assoc Physicians India 1998;46(9): 793–795. PMID: 11229250.
  7. Rajaram R, Rajagopalan RE, Pai M, Mahendran S. Survival after cardiopulmonary resuscitation in an urban Indian hospital. Nat Med J India 1999;12(5):51–55. PMID: 10416318.
  8. Sodhi K, Singla MK, Shrivastava A. Impact of advanced cardiac life support training program on the outcome of cardiopulmonary resuscitation in a Tertiary Care Hospital. Indian J Crit Care Med 2011;15(4):209–212. DOI: 10.4103/0972-5229.92070.
  9. Murali Chakravarthy, Sona Mitra, Latha Nonis. Outcomes of in-hospital, out of intensive care and operation theatre cardiac arrests in a tertiary referral hospital. Indian Heart J 2012;64(1)7–11. DOI: 10.1016/S0019-4832(12)60003-0.
  10. Chakravarthy M, Mitra S, Nonis L, Yellappa N. Outcome of in-hospital, out of intensive care and operation room cardiac arrests in a tertiary referral hospital in India: Comparison of outcomes of two audits. Indian J Anaesth 2014;58(4):479–481. DOI: 10.4103/0019-5049.139019.
  11. Dutta B, Garg R, Trikha A, Rewari V. A prospective audit on outcome of cardiac arrests at a tertiary care referral institute. J Cardiol Curr Res 2014:1(5):00027. DOI: 10.15406/jccr.2014.01.00027.
  12. Surinder Singh, Ajai Vikram Singh. Assessment of CPR for Patients Upshot and their Predictors: A Code Blue Team Approach. IJAR 2015;1(10):528–532. ISSN print: 2394-7500, ISSN online: 2394-5869.
  13. Joshi M. A prospective study to determine the circumstances, incidence and outcome of cardiopulmonary resuscitation in a referral hospital in India, in relation to various factors. Indian J Anaesth 2015;59(1):31–36. DOI: 10.4103/0019-5049.149446.
  14. Pandian GR, Thampi SM, Chakraborty N, Kattula D, Kundavaram PP. Profile and outcome of sudden cardiac arrests in the emergency department of a tertiary care hospital in South India. J Emerg Trauma Shock 2016;9(4):139–145. DOI: 10.4103/0974-2700.193348.
  15. Singh S, Namrata, Grewal A, Gautam PL, Luthra N, Tanwar G, et al. Evaluation of cardiopulmonary resuscitation (CPR) for patient outcomes and their predictors. J Clin Diagn Res 2016;10(1): UC01–UC04. DOI: 10.7860/JCDR/2016/14773.7012.
  16. Bansal A, Singh T, Ahluwalia G, Singh P. Outcome and predictors of cardiopulmonary resuscitation among patients admitted in Medical Intensive Care Unit in North India. Indian J Crit Care Med 2016;20(3):159–163. DOI: 10.4103/0972-5229.178179.
  17. Krishna CK, Showkat HI, Taktani M, Khatri V. Out of hospital cardiac arrest resuscitation outcome in North India - CARO study. World J Emerg Med 2017;8(3):200–205. DOI: 10.5847/wjem.j.1920-8642.2017.03.007.
  18. Monangi S, Setlur R, Ramanathan R, Bhasin S, Dhar M. Analysis of functioning and efficiency of a code blue system in a tertiary care hospital. Saudi J Anaesth 2018;12(2):245–249. DOI: 10.4103/sja.SJA_613_17.
  19. Grewal CS, Singh B, Bansal R, Sidhu US, Gupta D, Tandon R, et al. Outcome in survivors of out-of-hospital cardiac arrest in a tertiary care center of North India: A prospective observational study. J Pract Cardiovasc Sci 2018;4(3):193–197. DOI: 10.4103/jpcs.jpcs_53_18.
  20. Pareek M, Parmar V, Badheka J, Lodh N. Study of the impact of training of registered nurses in cardiopulmonary resuscitation in a tertiary care center on patient mortality. Indian J Anaesth 2018;62(5): 381–384. DOI: 10.4103/ija.IJA_17_18.
  21. Kapoor MC, Rao SC, Mishra BB. Indian society of anaesthesiologists cardiopulmonary resuscitation guidelines: Ushering in a new initiative. Indian J Anaesth 2017;61(11):865–866. DOI: 10.4103/ija.IJA_650_17.
  22. Trichur RV. Need for resuscitation registry in India based on Indian society of Anaesthesiologists cardiopulmonary resuscitation guidelines. Indian J Anaesth 2017;61(11):895–896. DOi: 10.4103/ija.IJA_680_17.
  23. Ian Jacobs, Nadkarni V, Bahr J, Berg RA, Billi JE, Bossaert L, et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries. A statement for healthcare professionals from a task force of the international liaison committee on resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa). Resuscitation 2004;63(3):233–249. DOI:
  24. Perkins GD, Jacobs IG, Nadkarni VM, Berg RA, Bhanji F, Biarent D, et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update of the Utstein resuscitation registry templates for out-of-hospital cardiac arrest: A statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation. Circulation. 2015;132(13):1286–1300. DOI: 10.1161/CIR.0000000000000144.
  25. Jerry P. Nolan, Robert A. Berg, Lars W. et al. On behalf of the Utstein collaborators. cardiac arrest and cardiopulmonary resuscitation outcome reports: Update of the utstein uesuscitation registry template for In-hospital cardiac arrest. Resuscitation 2019;144:166–177.
  26. Nolan JP, Soar J, Smith GB, Gwinnutt C, Parrott F, Power S, et al. Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit. Resuscitation 2014;85(8): 987–992. DOI: 10.1016/j.resuscitation.2014.04.002.
  27. Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, et al. Heart disease and stroke statistics-2018 Update: A report from the American Heart Association, American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Circulation 2018;137(12):e67–e492. DOI: 10.1161/CIR.0000000000000558.
  28. Perman SM, Stanton E, Soar J, Berg RA, Donnino MW, Mikkelsen ME, et al. Location of In-hospital Cardiac Arrest in the United States-variability in event rate and outcome, American Heart Association's Get with the guidelines®—Resuscitation (formerly the National Registry of cardiopulmonary resuscitation) Investigators. J Am Heart Assoc 2016;5(10): e003638. DOI: 10.1161/JAHA.116.003638.
  29. Hasselqvist-Ax I, Riva G, Herlitz J, Rosenqvist M, Hollenberg J, Nordberg P, et al. Early cardiopulmonary resuscitation in out-of-hospital cvardiac arrest. N Engl J Med 2015;372(24):2307–2315. DOI: 10.1056/NEJMoa1405796.
  30. Ringh M, Rosenqvist M, Hollenberg J, Jonsson M, Fredman D, Nordberg P, et al. Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiac arrest. N Engl J Med 2015;372(24):2316–2325. DOI: 10.1056/NEJMoa1406038.
  31. Kragholm K, Wissenberg M, Mortensen RN, Hansen SM, Malta Hansen C, Thorsteinsson K, et al. Bystander efforts and 1-Year outcomes in out-of-hospital cardiac arrest. N. Engl J Med 2017;376(18):1737–1747. DOI: 10.1056/NEJMoa1601891.
  32. Adnet F, Triba MN, Borron SW, Lapostolle F, Hubert H, Gueugniaud PY, et al. Cardiopulmonary resuscitation duration and survival in out-of-hospital cardiac arrest patients. Resuscitation 2017;111:74–81. DOI: 10.1016/j.resuscitation.2016.11.024.
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