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Web Exclusives |16 May 2017

Annals for Hospitalists Inpatient Notes - Predicting Codes—A Future With Fewer In-Hospital Cardiac Arrests

Dana P. Edelson, MD, MS; Matthew M. Churpek, MD, MPH, PhD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • From University of Chicago Medical Center, Chicago, Illinois.

    Disclosures: Dr. Edelson reports research support from Philips Healthcare and EarlySense and an ownership interest in Quant HC, which is developing products for risk stratification of hospitalized patients. Both Dr. Edelson and Dr. Churpek have a patent pending for risk stratification algorithms for hospitalized patients. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-0920.

    Requests for Single Reprints: Dana P. Edelson, MD, MS, Section of Hospital Medicine, University of Chicago Medical Center, 5841 South Maryland Avenue, MC 5000, Chicago, IL 60637; e-mail, dperes@uchicago.edu.

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Survival from in-hospital cardiac arrest (IHCA) has nearly doubled in recent years, probably because of improvements in cardiopulmonary resuscitation (1). Although many hospitalists recognize the need to provide high-quality chest compressions and rapid defibrillation, fewer may be aware that a large portion of arrests that occur in the hospital are predictable and, quite possibly, preventable.
In contrast to out-of-hospital cardiac arrest, IHCA often relates to progressive deterioration of a noncardiac medical condition (such as sepsis or respiratory failure). It is clear that vital sign abnormalities, such as tachypnea, tachycardia, and hypotension, in hospital settings are often evident many hours before cardiac arrest. In fact, such findings spurred the development and proliferation of rapid response teams (RRTs). Although a multicenter randomized controlled trial failed to demonstrate any benefit of RRTs, a recent meta-analysis suggested that the implementation of RRTs is associated with decreased IHCA rates and in-hospital mortality (2).
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Edelson DP, Churpek MM. Annals for Hospitalists Inpatient Notes - Predicting Codes—A Future With Fewer In-Hospital Cardiac Arrests. Ann Intern Med. 2017;166:HO2–HO3. doi: 10.7326/M17-0920

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Published: Ann Intern Med. 2017;166(10):HO2-HO3.

DOI: 10.7326/M17-0920

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2017 American College of Physicians
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