ArticleCritical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine2026
In-hospital cardiac arrest in a Singaporean tertiary hospital: Epidemiology, outcomes, and potential suboptimal end-of-life planning.
Article in Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the characteristics, antecedents, and outcomes of in-hospital cardiac arrests (IHCAs) in a Singaporean tertiary hospital. Design: We conducted a retrospective review of electronic medical records of all IHCAs that occurred in the general ward from January to December 2022 at Changi General Hospital. Based on pre-arrest characteristics, IHCAs were categorised as "potential suboptimal end-of-life planning (SELP)", "potentially predictable", or "sudden and unexpected". Main outcome measures: Primary outcomes were IHCA incidence and survival to hospital discharge. Secondary outcomes included the proportion of potential SELP cases and the frequency of pre-arrest extent of care (EOC) documentation. Results: There were 50 IHCAs among 52 617 admissions (0.95/1000 admissions). The median age was 72.5 (interquartile range [IQR], 63-81) years, and 82% had a Clinical Frailty Scale score of Conclusions: Our data corroborate that witnessed arrests, shorter downtime, and sustained ROSC are associated with better outcomes. However, the high prevalence of potential SELP and low rates of documented EOC reveal critical gaps in end-of-life planning within a frail inpatient population. Earlier, routine EOC discussions may help align care with patient goals, optimising resource utilisation and reducing potentially avoidable IHCAs.
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