Keywords
In-hospital cardiac arrest
Return of spontaneous circulation
Emergency
Survival
Submitted : 2026-03-04
Accepted : 2026-03-19
Published : 2026-04-03
Abstract
Objective: To investigate the influencing factors and prognosis of the return of spontaneous circulation (ROSC) in patients with unexpected in-hospital cardiac arrest (IHCA) under the rapid response system. Methods: According to the Utstein template, a retrospective analysis was conducted on the clinical data of 263 patients with unexpected IHCA from a tertiary-level hospital in Zhenjiang City from May 2019 to May 2024. The primary outcomes were categorized into the ROSC group and the Non-ROSC group based on post-resuscitation outcomes, while the secondary outcomes were divided into the discharged alive group and the non-discharged alive group. Logistic regression analysis was employed to identify the influencing factors and prognosis of ROSC, and the Kaplan-Meier method was used to plot survival curves. Results: (1) A total of 263 patients with IHCA were included in this study, with 166 cases (63.5%) achieving ROSC and 54 cases (32.5%) surviving for 7 days, among whom 42 cases (15.9%) were discharged alive. (2) Multivariate regression analysis revealed that age, abnormal BMI, duration of cardiopulmonary resuscitation (CPR), ventilation method during resuscitation, and the initial cumulative dosage of epinephrine were independent influencing factors for Non-ROSC in IHCA patients (p < 0.05). The NRS2002 score, recurrent resuscitation events, initial cumulative dosage of epinephrine, and duration of CPR were independent influencing factors for non-discharge alive in IHCA patients (p < 0.05). Conclusion: The ROSC rate of IHCA under the rapid response system has improved, but the rate of discharged alive remains relatively low. The system plays a certain role in reducing in-hospital mortality; however, further strengthening of the links in each stage is necessary to enhance patient prognosis.
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