Key statistics from the National Cardiac Arrest Audit 2016/17
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1 Key statistics from the National Cardiac Arrest Audit 216/17 Supported by Resuscitation Council (UK) and Intensive Care National Audit & Research Centre (ICNARC)
2 Data collection scope (NCAA Version 1.3) NCAA data are collected for all individuals (excluding neonates) receiving chest compression(s) and/or defibrillation and attended by the hospital-based resuscitation team (or equivalent) in response to a 2222 call. Available data This report is based on data for in-hospital cardiac arrests in NHS acute hospitals. The following team visits were therefore excluded: Team visits taking place in specialist or non-acute hospitals Team visits taking place in paediatric hospitals Team visits (meeting the scope of NCAA) in response to pre-hospital cardiac arrests Year Number of hospitals participating in NCAA Total number of admissions to hospital Total number of reported in-hospital cardiac arrests Total number of individuals April 216 March ,234,48 16,21 15,645 April 215 March ,73,623 16,945 16,312 April 214 March ,297,994 16,92 15,517 April 213 March ,76,474 14,14 13,643 April 212 March ,647,963 13,867 13,351 2 NCAA 217
3 Incidence of in-hospital cardiac arrests attended by the team Number of in-hospital cardiac arrests attended by the team Number of in-hospital cardiac arrests attended by the team 2, 1,5 1, 5 Apr 216 May 216 Jun 216 Jul 216 Aug 216 Sep 216 Oct 216 Nov 216 Month of 2222 call Dec 216 Jan 217 Feb 217 Mar 217 Monthly number Average over period NCAA 217 Rate of in-hospital cardiac arrests per 1 hospital admissions Number of in-hospital cardiac arrests attended by the team per 1 hospital admissions Apr 216 May 216 Jun 216 Jul 216 Aug 216 Sep 216 Oct 216 Nov 216 Month of 2222 call Dec 216 Jan 217 Feb 217 Mar 217 Monthly rate 95% CI Average over period NCAA NCAA 217
4 Trends in incidence of in-hospital cardiac arrests attended by the team Number of in-hospital cardiac arrests attended by the team Number of in-hospital cardiac arrests attended by the team 5, 4, 3, 2, 1, Apr-Jun 212 Jul-Sep 212 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 Jan-Mar 217 NCAA 217 Note: number of hospitals participating in NCAA has increased over time Rate of in-hospital cardiac arrests per 1 hospital admissions Number of in-hospital cardiac arrests attended by the team per 1 hospital admissions Apr-Jun 212 Jul-Sep 212 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 Jan-Mar 217 NCAA NCAA 217
5 Patient characteristics Age (years), n (%) (1.) ,795 (23.4) ,671 (22.6) ,73 (31.3) 85+ 3,51 (21.7) Mean (SD) 72.3 (15.9) Median (IQR) 76 (65, 83) Sex, n (%) Female 6,711 (41.4) Male 9,499 (58.6) Reason for admission to/attendance at/visit to your hospital, n (%) Patient - trauma 478 (2.9) Patient - medical 13,722 (84.7) Patient - elective/scheduled surgery 746 (4.6) Patient - emergency/urgent surgery 1,21 (6.3) Patient - obstetric 27 (.2) Outpatient 166 (1.) Staff 9 (.1) Visitor 39 (.2) Missing 2 (.) IQR, interquartile range; SD, standard deviation. 5 NCAA 217
6 Trends in patient characteristics Mean age 8 Mean age (years) Sex: Male Sex: Male (%) Apr-Jun 212 Jul-Sep 212 Reason for attendance: Medical Reason for attendance: Medical (%) Apr-Jun 212 Jul-Sep 212 Apr-Jun 212 Jul-Sep 212 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 Jan-Mar 217 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 Jan-Mar 217 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 Jan-Mar 217 NCAA 217 NCAA 217 NCAA NCAA 217
7 Team visit characteristics Number of days from admission to 2222 call, n (%) 4,252 (26.2) 1 2,836 (17.5) 2-7 5,387 (33.2) 8-3 3,122 (19.3) >3 612 (3.8) Missing 1 (.) Mean (SD) 6.3 (13.4) Median (IQR) 2 (, 7) Location of arrest, n (%) Emergency department 1,543 (9.5) Emergency admissions unit 1,258 (7.8) Theatre & recovery 248 (1.5) Imaging department 248 (1.5) Cardiac catheter laboratory 52 (3.2) Specialist treatment area 22 (1.4) ICU or ICU/HDU 891 (5.5) HDU 219 (1.4) PICU 27 (.2) PHDU 15 (.1) Coronary care unit 1,65 (9.9) Other intermediate care area 21 (.1) Obstetrics area 21 (.1) Ward 9,187 (56.7) Other internal location 17 (.1) Clinic 63 (.4) Non-clinical area 16 (.7) Missing 1 (.) Status at team arrival, n (%) Dead - resuscitation stopped 155 (1.) Resuscitation ongoing 13,714 (84.6) ROSC achieved before team arrival 1,468 (9.1) Deteriorating (not yet arrested) 857 (5.3) Missing 16 (.1) Presenting/first documented rhythm, n (%) Shockable - VF 1,713 (1.6) Shockable - VT 815 (5.) Shockable - unknown rhythm 72 (.4) Non-shockable - asystole 3,318 (2.5) Non-shockable - PEA 8,551 (52.8) Non-shockable - bradycardia 7 (.4) Non-shockable - unknown rhythm 294 (1.8) Never determined 81 (4.9) Unknown 576 (3.6) HDU, high dependency unit; ICU, intensive care unit; IQR, interquartile range; PEA, pulseless electrical activity; PHDU, paediatric high dependency unit; PICU, paediatric intensive care unit; ROSC, return of spontaneous circulation; SD, standard deviation; VF, ventricular fibrillation; VT, ventricular tachycardia. 7 NCAA 217
8 Trends in team visit characteristics Mean number of days from admission to 2222 call 8 Mean number of days from admission to 2222 call Location of arrest: Ward Location of arrest: Ward (%) Apr-Jun 212 Jul-Sep 212 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Apr-Jun 212 Jul-Sep 212 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 Jan-Mar 217 NCAA 217 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 Jan-Mar 217 Status at team arrival: Resuscitation ongoing 1 NCAA 217 Status at team arrival: Resuscitation ongoing (%) Apr-Jun 212 Jul-Sep 212 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 Jan-Mar 217 NCAA NCAA 217
9 Presenting/first documented rhythm Percentage of in-hospital cardiac arrests Apr-Jun 212 Jul-Sep 212 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 Jan-Mar 217 Shockable - VF/VT Non-shockable - asystole Non-shockable - PEA NCAA NCAA 217
10 Outcomes Reason resuscitation stopped at end of team visit, n (%) Alive - ROSC > 2 minutes 8,82 (49.9) Dead - ROSC < 2 minutes 1,2 (6.2) Dead - no ROSC 5,857 (36.1) Dead - DNACPR 383 (2.4) Dead - futility 885 (5.5) Missing 1 (.) Post-arrest location, n (% of ROSC > 2 minutes) Emergency admissions unit 268 (3.3) ICU or ICU/HDU 2,782 (34.4) HDU 171 (2.1) PICU 38 (.5) PHDU 8 (.1) CCU 1,497 (18.5) Other intermediate care area 19 (.2) Obstetrics area 2 (.) Ward 1,89 (22.4) Other internal location 7 (.1) Mortuary 1,161 (14.4) Other hospital 292 (3.6) Not in hospital 27 (.3) Missing 1 (.) CPC at hospital discharge, n (% of adult survivors) 1 2,676 (85.) 2 39 (9.8) 3 85 (2.7) 4 11 (.3) Missing 68 (2.2) CPC, cerebral performance category; DNACPR, do not attempt cardiopulmonary resuscitation; HDU, high dependency unit; ICU, intensive care unit; PHDU, paediatric high dependency unit; PICU, paediatric intensive care unit; ROSC, return of spontaneous circulation. 1 NCAA 217
11 Outcome flow All percentages are reported as the percentage of all individuals (N=15,645). 11 NCAA 217
12 Trends in outcomes Reason resuscitation stopped: ROSC > 2 minutes 5 ROSC > 2 minutes (%) Apr-Jun 212 Jul-Sep 212 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Post-arrest location: ICU or ICU/HDU Post-arrest location: ICU or ICU/HDU (% of ROSC > 2 minutes) Survival to hospital discharge Survival to hospital discharge (% of individuals) Apr-Jun 212 Jul-Sep 212 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 Jan-Mar 217 Apr-Jun 212 Jul-Sep 212 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 Jan-Mar 217 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 Jan-Mar 217 NCAA 217 NCAA 217 NCAA NCAA 217
13 CPC at hospital discharge (adult survivors) 1 Percentage of adult survivors Apr-Jun 212 Jul-Sep 212 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 CPC 1 or 2 CPC 3 or 4 CPC missing Jan-Mar 217 NCAA NCAA 217
14 Outcomes by patient subgroups ROSC > 2 minutes Subgroup Number of in-hospital cardiac arrests* Number with ROSC > 2 min Percentage (95% confidence interval) Overall 16,29 8, (49.1, 5.6) By presenting rhythm: Shockable - VF/VT 2,528 1, (76.2, 79.4) Non-shockable - asystole 3, (28.1, 31.2) Non-shockable - PEA 8,551 3, (45.1, 47.2) By age group (years): (56.3, 71.) ,795 2, (57.2, 6.4) ,67 1, (5.9, 54.1) ,73 2, (46.4, 49.1) 85+ 3,51 1, (38.2, 41.5) PEA, pulseless electrical activity; ROSC, return of spontaneous circulation; VF, ventricular fibrillation; VT, ventricular tachycardia. * Excluding arrests missing reason resuscitation stopped (N=1). Survival to hospital discharge Subgroup Number of individuals* Number of hospital survivors Percentage (95% confidence interval) Overall 15,587 3, (19.8, 21.1) By presenting rhythm: Shockable - VF/VT 2,313 1, (47.7, 51.8) Non-shockable - asystole 3, (7.4, 9.3) Non-shockable - PEA 8,268 1, (12.5, 13.9) By age group (years): (42.4, 58.3) ,591 1, (29.4, 32.4) , (2.6, 23.4) , (16.1, 18.2) 85+ 3, (1.5, 12.7) PEA, pulseless electrical activity; VF, ventricular fibrillation; VT, ventricular tachycardia. * Excluding individuals still in hospital (N=56) or missing hospital survival (N=2). 14 NCAA 217
15 Trends in outcomes by patient subgroups ROSC > 2 minutes by presenting/first documented rhythm 8 ROSC > 2 minutes (%) Apr-Jun 212 Jul-Sep 212 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 Jan-Mar 217 Shockable - VF/VT Non-shockable - asystole Non-shockable - PEA ROSC > 2 minutes by age group ROSC > 2 minutes (%) Apr-Jun 212 Jul-Sep 212 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 NCAA 217 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec Jan-Mar 217 NCAA NCAA 217
16 Survival to hospital discharge by presenting/first documented rhythm Survival to hospital discharge (% of individuals) Apr-Jun 212 Jul-Sep 212 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec 216 Jan-Mar 217 Shockable - VF/VT Non-shockable - asystole Non-shockable - PEA Survival to hospital discharge by age group Survival to hospital discharge (% of individuals) Apr-Jun 212 Jul-Sep 212 Oct-Dec 212 Jan-Mar 213 Apr-Jun 213 NCAA 217 Jul-Sep 213 Oct-Dec 213 Jan-Mar 214 Apr-Jun 214 Jul-Sep 214 Oct-Dec 214 Jan-Mar 215 Apr-Jun 215 Jul-Sep 215 Oct-Dec 215 Jan-Mar 216 Apr-Jun 216 Jul-Sep 216 Oct-Dec Jan-Mar 217 NCAA NCAA 217
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