Comparing characteristics and outcomes of in-hospital cardiac arrest during the early and late COVID-19 pandemic at an academic institution in Saudi Arabia.

BACKGROUND: The COVID-19 pandemic has introduced major changes in the resuscitation practices of cardiac arrest victims. AIM: We aimed to compare the characteristics and outcomes of patients who sustained in-hospital cardiac arrest (IHCA) during the early COVID-19 pandemic period (2020) with those during the late COVID-19 pandemic period (2021). METHODS: This was a retrospective review of adult patients sustaining IHCA at a single academic centre. We compared characteristics and outcomes of IHCA for 5 months in 2020 with those experiencing IHCA for 5 months in 2021. RESULTS: Patients sustaining IHCA during the early COVID-19 pandemic period had higher rates of delayed epinephrine administration of more than 5 min (13.4% vs. 1.9%; p < 0.01), more frequent delays in the initiation of chest compressions (55.6% vs. 17.9%; p < 0.01), and were intubated less often (23.0% vs. 59.3%; p < 0.01). In terms of outcomes, both return of spontaneous circulation (35.8% vs. 51.2%; p < 0.01) and survival to hospital discharge rates (13.9% vs. 30.2%; p < 0.01) were lower during the early COVID-19 pandemic period. CONCLUSIONS: The early COVID-19 pandemic period was associated with delays in epinephrine administration and chest compression initiation for IHCA. Moreover, both return of spontaneous circulation and survival to hospital discharge were lower during the early COVID-19 pandemic period.

Frequency and Risk Factors of Unplanned 30-Day Readmission After Open Heart Surgeries: A Retrospective Study in a Tertiary Care Center.

BACKGROUND: Unplanned 30-day readmission post-cardiac surgery imposes higher risks for complications, increased costs, and unfavorable events for the care provider and patient. This study was to determine the unplanned readmission rate, determinants, and most common events within 30 days post-cardiac surgery. Recommendations to prevent or minimize these complications are included. METHODS: Setting and design - a retrospective record review was conducted among all adult patients, who underwent open heart surgery between 2010 and 2020 at King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia. Using Google Forms, we manually collected data from hospital records. STATISTICAL ANALYSIS USED: binomial logistic regression model (using the backward stepwise method). Regression outcomes were expressed as odds ratios (ORs) and 95% CIs. A P-value of < 0.05 indicated statistical significance. RESULTS: Among 400 patients who underwent cardiac surgery, 343 patients were included in the study, including 53 unplanned readmissions, which was a rate of 16.3% (95% CI, 12.8 to 20.6%). The most frequently reported reasons for readmission were sternal wound infections (7.3%), pleural effusion (2.0%), and heart failure (1.7%). Female gender, high postoperative LDH and urea were the most important risk factors. CONCLUSION: Discharge planning, patient education, and cardiac surgery nurse home visit constitute the most important factors to minimize 30 days of unplanned readmission.