DOI: 10.4103/jica.jica_25_26 ISSN: 2949-7426

Outcomes and Factors Influencing Survival after In-hospital Cardiopulmonary Resuscitation and Emergency Triage: A Retrospective Observational Study

Krishna Kumar Mylavarapu, Balachandran Nambiar, Sudershan Garg, Josemine Davis, Aditya Joshi
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Abstract

Introduction:

Code Blue events are urgent hospital emergencies requiring immediate resuscitation. In hospitals lacking a dedicated medical emergency response team, Code Blue teams handle both cardiac arrests and nonarrest emergencies. We aimed to assess Code Blue outcomes by comparing true cardiac arrests requiring cardiopulmonary resuscitation (CPR) with cases of acute physiological deterioration without arrest.

Materials and Methods:

The study analyzed 288 Code Blue activations at a 1250-bed tertiary hospital in North India from January 2023 to June 2024. Patients were divided into Group I (True cardiac arrest receiving CPR) and Group II (Prearrest/Rapid response without CPR). The main outcomes assessed were ROSC and survival to discharge for Group I, and ICU transfer rate and hospital survival to discharge for Group II. Categorical variables were compared using the Chi-square test.

Results:

Among 288 activations, males comprised 64.2% ( n = 185; mean age: 57.9 years) and females 35.8% ( n = 103; mean age: 57.1 years). Most calls originated in the emergency center (48.3%, n = 139). Group I comprised 45.1% ( n = 130) of cases, with a ROSC rate of 26.2% ( n = 34). CPR duration < 30 min was the primary predictor of ROSC ( P < 0.001). Successful resuscitations required significantly shorter CPR duration (20.9 ± 9.0 min) than unsuccessful attempts (42.6 ± 5.9 min). Group II accounted for 54.8% ( n = 158) of activations. Overall, 56.9% ( n = 164) of patients were admitted to the ICU, and 81.7% ( n = 134) were discharged alive with good neurological recovery.

Conclusion:

True cardiac arrests accounted for less than half of Code Blue activations. Differentiating cardiac arrest teams from dedicated rapid response teams is essential to optimize emergency resource allocation.

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