Hastane İçi Kardiyak Arrest Olgularında Sağkalım ve ROSC Belirleyicileri ile Mesai İçi/Mesai Dışı Zaman Dilimlerinin Nörolojik Sonlanıma Etkisi: Tek Merkezli Retrospektif Analiz

Abstract

Amaç: Bu çalışmada, hastane içi kardiyak arrest (HİKA) olgularında mesai saatlerinin spontan dolaşımın geri dönüşü (ROSC), nörolojik sonlanım ve hastane sağkalımı üzerindeki etkilerinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Düzce Üniversitesi Hastanesi’nde Ocak 2022–Temmuz 2025 tarihleri arasında gerçekleşen 318 mavi kod çağrısı geriye dönük olarak incelendi. Gerçek kardiyak arrest tanısı doğrulanan 93 olgu çalışmaya dâhil edildi. Hastaların demografik özellikleri, ilk ritim tipi, müdahale süresi, defibrilasyon uygulanması, ROSC gelişimi, yoğun bakım yatışı, hastane sağkalımı ve nörolojik sonlanımı (CPC skoru) kaydedildi. Olgular mesai içi (08:00–16:00) ve mesai dışı (16:00–08:00 ve hafta sonları) saatlere göre iki gruba ayrılarak karşılaştırıldı. Bulgular: Olguların medyan yaşı 65 (55–78) yıl olup %55,9’u erkekti. Genel ROSC oranı %44,1, hastane sağkalımı %34,4 olarak saptandı. Mesai içi saatlerde ROSC oranı (%65,6) ve nörolojik sonlanım (medyan CPC: 1), mesai dışına kıyasla anlamlı derecede daha iyiydi (%32,2 ve medyan CPC: 5; p<0,01). Çok değişkenli analizde yalnızca müdahale süresi ROSC ile ilişkili bulundu. Sonuç: Mesai içi saatlerde gerçekleşen HİKA olgularında ROSC ve nörolojik sonuçlar daha iyidir. Bulgular, özellikle mesai dışı saatlerde resüsitasyon ve post-resüsitasyon bakım süreçlerinin güçlendirilmesi gerektiğini göstermektedir.

Keywords

• Hastane içi kalp durması
• acil durum kodu
• kardiyopulmoner resüsitasyon
• spontan dolaşımın geri dönüşü
• nörolojik sonuç
• beyin performans kategorisi

Survival and ROSC Determinants in In-Hospital Cardiac Arrest Cases and the Effect of On-Hour/Off-Hour Time Intervals on Neurological Outcome: A Single-Center Retrospective Analysis

Abstract

Aim: This study aimed to evaluate the effects of working hours on return of spontaneous circulation (ROSC), neurological outcome, and hospital survival in cases of in-hospital cardiac arrest (HICA). Materials and Methods: Thirty-eight blue code calls that occurred at Düzce University Hospital between January 2022 and July 2025 were retrospectively reviewed. Ninety-three cases with confirmed diagnosis of actual cardiac arrest were included in the study. Demographic characteristics, initial rhythm type, intervention time, defibrillation application, development of ROSC, intensive care unit admission, hospital survival, and neurological outcome (CPC score) of the patients were recorded. The cases were divided into two groups according to working hours (08:00–16:00) and off-hours (16:00–08:00 and weekends) and compared. Result: The median age of the cases was 65 (55–78) years, and 55.9% were male. The overall ROSC rate was 44.1%, and hospital survival was 34.4%. During working hours, the ROSC rate (65.6%) and neurological outcome (median CPC: 1) were significantly better compared to outside working hours (32.2% vs. median CPC: 5; p<0.01). In multivariate analysis, only the intervention time was found to be associated with ROSC. Conclusion: ROSC and neurological outcomes are better in HIKA cases that occur during working hours. The findings suggest that resuscitation and post-resuscitation care processes should be strengthened, especially during off-hours.

Keywords

• In-hospital cardiac arrest
• emergency medical response
• cardiopulmonary resuscitation
• return of spontaneous circulation
• neurological outcome
• cerebral performance category

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