Retrospective analysis of case of cardiopulmonary arrest attending to Bezmialem Vakif University emergency department and brought by 112 ambulance teams during the COVID-19 pandemic period

Cardiopulmonary arrest (CPA) is the sudden cessation of spontaneous breathing and circulation for any reason. All procedures performed for the treatment of CPA constitute cardiopulmonary resuscitation (CPR). According to the European Resuscitation Council 2021 guide data; Sudden cardiac arrests constitute 50% of deaths due to coronary heart diseases. In the Covid-19 pandemic, emergency services have been under a great burden as the first step of admission all over the world. In this study, out-of-hospital cardiac arrest (HDKA) cases brought to the emergency room during the Covid-19 period were examined. This study was carried out retrospectively by including 190 non-traumatic CPA cases over the age of 18 years who were brought to the emergency department of Bezmialem Vakif University Hospital after the approval of the ethics committee. Emergency room epicrisis reports of patients with KPA diagnosis code were obtained from the hospital data processing center. Cases whose data could not be fully accessed from these patients and who were not treated as exitus at the time of admission were excluded from the study. All cases were investigated in terms of demographic and clinical characteristics such as age groups, gender, Covid-19 status, mode of admission to the hospital, patient outcome, presence of comobidity, drug use, airway applied outside the hospital, witnessing arrest, and arrival time to the emergency room. The effects of these features on patient outcome were analyzed statistically. 190 patients were included in our study. The mean age of the patients was 66.2%, and 66.3% (n=126) were men and 33.7% (n=64) were women. It was observed that patients aged 65 and over applied to the emergency department more often with HDCA, with 57.6% (n=110). It was determined that 67.9% (n=129) of the cases who underwent CPR were exitus. The rate of Spontaneous Circulatory Return (SDGD) in cases with CPA was found to be significantly higher, 33.5% (p=0.04). Significant differences were found according to the accompanying comorbidity status. In the cases with 10 minutes or less CPR time outside the hospital, the ROGD rate was found to be significantly higher with 42.3% (p=0.03). In our study, CPA cases, which were the intervention of emergency health services, were more common in males (66.3%). Exit rates are higher in patients with HT (76.5%), DM (56.3%), LVH (54.5%), CKD (57.9%) and malignancy (72.4%) as comorbid diseases. It is seen that the intubation procedure applied before the emergency service has a positive effect on the SDGD rate and the emergency service outcome (45.3%). Attempts by emergency health services to provide airway safety should be supported. It was determined that the exitus rates were lower in cases with CPA (66.5%). Mortality is high (94.3%) in CPR performed for 21 minutes or more. Medical records of KPA cases brought to the emergency department should be recorded more clearly and completely. It may be recommended to conduct more studies examining CPA arrest cases during the Covid-19 period. Keywords: Cardiac arrest, Cardiopulmonary resuscitation, emergency department, Covid-19