article · Health
This study examines the outcomes and associated factors of cardiopulmonary resuscitation for intrahospital cardiac arrests in two hospitals in North-Kivu, Democratic Republic of Congo. Across an 18-month prospective cohort of 84 adult patients, arrests were predominantly caused by combined factors or isolated hypoxia, with metabolic acidosis and electrolyte disturbances being common. While 47.6 percent of resuscitations began within four minutes of the arrest, initial cardiac rhythms were mostly asystole. Return of spontaneous cardiac activity was achieved in 42.9 percent of cases, significantly associated with resuscitation initiated by doctors and nurses as well as a history of cardiovascular disease. However, long-term survival was poor: only 8.3 percent of patients survived to day seven, and 6.0 percent survived to day thirty, highlighting critical limitations in post-resuscitation care and early prevention.
Intrahospital cardiac arrest is a critical emergency with low survival in resource-limited areas. By identifying the common reversible triggers, such as hypoxia and electrolyte imbalances, and measuring survival timelines, this research clarifies the clinical hurdles in low-resource hospitals. These findings demonstrate an urgent need to strengthen early alert protocols and sustained post-resuscitation care to improve long-term patient recovery.
The abstract does not indicate an application pathway or a basis for commercialisation, as it is an observational clinical cohort study focusing on hospital outcomes and resuscitation practices.
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Introduction: Intrahospital Cardiopulmonary Arrest (IHCA) is a common critical event with high morbidity and mortality in resource-limited settings. This study examines the outcomes of Cardiopulmonary Resuscitation (CPR) for IHCA and their associated factors in North-Kivu in the Democratic Republic of Congo. Methods: This is an 18-month prospective cohort study conducted in two hospitals located in North-Kivu Province: HEAL Africa and Kyondo General Reference Hospital. Data were analyzed using Fisher’s exact test for categorical data and multinomial regression. A p-value Results: We included 84 patients, 58.3% men, with a mean (SD) age of 57.7 years (±17.1). IHCA was due to a combination of causes in 39.3% and isolated hypoxia in 33.3%. Metabolic acidosis was observed in 50%. Hyponatremia and hyperkalemia were the most common electrolyte disturbances in patients with IHCA (52.8% and 44.4%, respectively). In 41.6% of cases, the alert was launched after CA, and 47.6% of CPR was initiated within 4 minutes of CA. Most resuscitations were led by residents. Asystole was noted in 83.3% of monitored patients. Advanced resuscitation with intubation was performed in 45.2% of patients. The rate of Return of Spontaneous Cardiac Activity (ROSC) after IHCA was 42.9%. The factors associated with ROSC were CPR initiated by doctors and nurses, and a history of cardiovascular diseases. The survival rate on the seventh and thirtieth day after ROSC was 8.3% and 6%, respectively. Three out of five patients had a complete recovery on the thirtieth day. Conclusion: IHCA in North-Kivu is due to multiple reversible causes and often occurs in patients with multiple combined illnesses and cardiovascular disease. Early detection and prevention measures for IHCA are still very limited. The ROSC rate for IHCA is high, contrasting with a very low survival rate at day 30 of IHCA.
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DOI: 10.4236/health.2025.1712099
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