Evidence map›Paper›PMID 41436259›Full record

Observational studyBMJ open2025

Temporal trends in the causes of in-hospital cardiac arrest: a retrospective observational cohort study on the limitations of the current alert system at a tertiary hospital in Korea.

Joong Min Lee, Min Soo Cho, Myung-Jin Cha, Jun Kim, Kee-Joon Choi, Ah-Ram Kim, Min-Seok Kim, JinMi Lee, Yujung Shin, Un Jung Go and 3 more

Abstract readObservational Study
In one paragraph

Observational study in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Joong Min LeeDepartment of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea (the Republic of).ORCID http://orcid.org/0000-0002-5354-2554
Min Soo ChoDepartment of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea (the Republic of).ORCID http://orcid.org/0000-0001-9867-4991
Myung-Jin ChaDepartment of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea (the Republic of).
Jun KimDepartment of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea (the Republic of).ORCID http://orcid.org/0000-0002-3573-638X
Kee-Joon ChoiDepartment of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea (the Republic of).
Ah-Ram KimDepartment of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea (the Republic of).ORCID http://orcid.org/0000-0003-2489-948X
Min-Seok KimDepartment of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea (the Republic of).ORCID http://orcid.org/0000-0003-0860-3650
JinMi LeeAsan Medical Center, Seoul, Korea (the Republic of).
Yujung ShinAsan Medical Center, Seoul, Korea (the Republic of).
Un Jung GoAsan Medical Center, Seoul, Korea (the Republic of).
Hae Yeon OhAsan Medical Center, Seoul, Korea (the Republic of).
Sang-Bum HongDivision of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea gbnam@amc.seoul.kr sbhong@amc.seoul.kr.
Gi-Byoung NamDepartment of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea (the Republic of) gbnam@amc.seoul.kr sbhong@amc.seoul.kr.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIn-hospital cardiac arrest (IHCA) is associated with high mortality and serious neurological sequelae. Although medical alert systems have evolved, the ability of these systems to influence changes in IHCA incidence and aetiology remains limited. DESIGNS: Retrospective observational cohort study. SETTINGS: A single tertiary hospital in South Korea, covering tertiary care levels.

participantsA total of 1994 adult patients (≥18 years) who experienced 2121 episodes of IHCA between January 2011 and December 2019. Patients with out-of-hospital cardiac arrest, those aged ≤18 years and those with do-not-resuscitate orders were excluded. The mean age of patients was 63.0 years (SD, 14.6); 64.1% were male.

interventionsNot applicable.

main outcome measuresThe incidence and temporal trends of IHCA were stratified by aetiology (cardiac vs non-cardiac). Additional analyses examined changes in arrhythmic versus non-arrhythmic causes over time using Poisson regression.

resultsCardiac arrhythmia was the most common cause of IHCA (314 of 2121, 14.8%; incidence: 0.42/1000 admissions), including ventricular tachycardia (n=86), ventricular fibrillation (n=87) and Torsades de Pointes (n=79). Respiratory failure was the second most common cause (266 of 2121, 12.5%; incidence: 0.36/1000 admissions). The incidence of IHCA due to respiratory failure in 2011 was 0.63/1000 admissions, which decreased to 0.20/1000 admissions by 2019 (β=0.883, 95% CI 0.842 to 0.926, p for trend 0.007; Poisson p<0.001). In contrast, the incidence of IHCA due to arrhythmia in 2011 was 0.49/1000 admissions and remained similar over time (0.29/1000 admissions in 2019, β=0.972, 95% CI 0.932 to 1.015, p for trend 0.194; Poisson p=0.198).

conclusionIHCA causes have shown significant temporal shifts. Arrhythmia has become the leading cause of IHCA, with incidences remaining stable, whereas a marked decrease has been observed in respiratory-related IHCA. Therefore, enhanced in-hospital cardiac monitoring systems are required for early detection.

Indexed as

Arrhythmias, CardiacHeart ArrestAgedFemaleHumansIncidenceMaleMiddle AgedRepublic of KoreaRetrospective StudiesTertiary Care CentersCARDIOLOGYDeath, Sudden, CardiacINTENSIVE & CRITICAL CARE

Identifiers

PMID41436259
PMCPMC12730767

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.