Clinical profile, management and outcome of patients developing cardiac arrest in the emergency medicine department of Muhimbili national hospital, Dar es salaam

Abstract

Background: Cardiac Arrests in the Emergency Medicine Department of Muhimbili National Hospital is not uncommon occurrence and in most of these, cardiopulmonary resuscitations are done in order to revive these patients’ lives. However little is known of their outcome in the department and beyond. Aim of the Study: To describe the clinical profile, management and outcome of all patients who develop cardiac arrest while receiving care in The Emergency Department of Muhimbili National Hospital (ED-MNH) in Dar es Salaam. Materials and Methods: This was a prospective cohort study of patients who developed cardiac arrest in the ED-MNH between August and December 2016. A structured case report forms were used to document the demographic, pre-ED course of illness, management in the ED, and outcome in the ED and overall hospital outcome of cardiac arrest patients. Data were summarized using descriptive statistics and analyzed using counts, proportions, median, interquartile ranges (IQR), 95% confidence interval (CI), relative risk (RR) and P-value. Results: A total of 68 cardiac arrests patients were enrolled out of 9431 who attended the department during the data collection period. The incidence rate was 7/1000. The median age of cardiac arrest was 39 years and males were slightly higher (54.4%) than females. Sepsis was the commonest diagnosis for cardiac arrest patients accounting for 28.4%. Those who attained Return of Spontaneous Circulation (ROSC) and survived at ED were 13.2%, however none survived up to 7 days. Conclusion and Recommendations: The study showed lower incidence of cardiac arrest at ED-MNH but whenever the arrest occurred, it had poor survival. Aggressive efforts are advocated to prevent the occurrence of cardiac arrest from critical patients. Further study is recommended with wider population size.