J Clin Monit Comput - Electrocardiogram characteristics prior to in-hospital cardiac arrest.


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Survival after in-hospital cardiac arrest (I-HCA) remains < 30 %. There is very limited literature exploring the electrocardiogram changes prior to I-HCA. The purpose of the study was to determine demographics and electrocardiographic predictors prior to I-HCA. A retrospective study was conducted among 39 cardiovascular subjects who had cardiopulmonary resuscitation from I-HCA with initial rhythms of pulseless electrical activity (PEA) and asystole. Demographics including medical history, ejection fraction, laboratory values, and medications were examined. Electrocardiogram (ECG) parameters from telemetry were studied to identify changes in heart rate, QRS duration and morphology, and time of occurrence and location of ST segment changes prior to I-HCA. Increased age was significantly associated with failure to survive to discharge (p < 0.05). Significant change was observed in heart rate including a downtrend of heart rate within 15 min prior to I-HCA (p < 0.05). There was a significant difference in heart rate and QRS duration during the last hour prior to I-HCA compared to the previous hours (p < 0.05). Inferior ECG leads showed the most significant changes in QRS morphology and ST segments prior to I-HCA (p < 0.05). Subjects with an initial rhythm of asystole demonstrated significantly greater ECG changes including QRS morphology and ST segment changes compared to the subjects with initial rhythms of PEA (p < 0.05). Diagnostic ECG trends can be identified prior to I-HCA due to PEA and asystole and can be further utilized for training a predictive machine learning model for I-HCA.

Resumo Limpo

surviv inhospit cardiac arrest ihca remain limit literatur explor electrocardiogram chang prior ihca purpos studi determin demograph electrocardiograph predictor prior ihca retrospect studi conduct among cardiovascular subject cardiopulmonari resuscit ihca initi rhythm pulseless electr activ pea asystol demograph includ medic histori eject fraction laboratori valu medic examin electrocardiogram ecg paramet telemetri studi identifi chang heart rate qrs durat morpholog time occurr locat st segment chang prior ihca increas age signific associ failur surviv discharg p signific chang observ heart rate includ downtrend heart rate within min prior ihca p signific differ heart rate qrs durat last hour prior ihca compar previous hour p inferior ecg lead show signific chang qrs morpholog st segment prior ihca p subject initi rhythm asystol demonstr signific greater ecg chang includ qrs morpholog st segment chang compar subject initi rhythm pea p diagnost ecg trend can identifi prior ihca due pea asystol can util train predict machin learn model ihca

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