The impact of changes in cardiopulmonary resuscitation practices on survival in in-hospital cardiac arrest patients during the Covid-19 pandemic

The Covid-19 pandemic has caused changes in cardiopulmonary resuscitation applications as well as in all practices. In this research, we evaluated the effects of these changes on the management and outcomes of in-hospital cardiac arrest cases. Our study is a single-center, retrospective, observational study. It was conducted with 628 patients with in-hospital arrest who met the study criteria between January 1, 2018, and January 1, 2022. The cases were evaluated in two groups as pre-guideline period and post-guideline period interventions according to the cardiopulmonary resuscitation algorithm published on October 21. Study data were obtained from the hospital automation system, patient files, and clinical data. In the results of the study, the confidence interval was 95% and the statistical significance level was accepted as p<0.05. Mean age of 628 patients was 70.58±15.42 years, the range was between 18-97, and 292 (46.5%) of the patients were female. After the changes in the algorithm, there was no significant difference in terms of age, gender, and intervention time in the cases that were intervened pre/post-guideline period. Mortality was found to be significantly lower in patients who underwent cardiopulmonary resuscitation post-guideline period (p=0.001). It was determined that the survival rate after the guideline (OR:2.492. 95%Cl:1.473-4.217. p=0.001) was higher regardless of age, gender, and survival time of the survivors. There was no significant difference between the survival durations of the cases after post-resuscitation, in the pre-guideline and post-guideline period cases. Mortality rates after cardiopulmonary resuscitation were found to be significantly lower in cardiac arrest cases after Covid-19. However, these results need to be supported by more studies before they can be generalized.