Key statistics from the National Cardiac Arrest Audit

Supported by Resuscitation Council (UK) and Intensive Care National Audit & Research Centre (ICNARC)

Key statistics from the

National Cardiac Arrest Audit

2019/20

Key Statistics from the National Cardiac Arrest Audit 2019/20

2 © NCAA 2020

Data collection scope (NCAA Version 1.4)

NCAA data are collected on any resuscitation event commencing in-hospital where an individual receives chest compression(s) and/or defibrillation and is attended by the hospital-based resuscitation team (or equivalent) in response to a 2222 call.

Note: The data collection scope changed on 1 April 2018

Available data

This report is based on data for in-hospital cardiac arrests in NHS acute hospitals. The following team visits were therefore excluded:

• Team visits taking place in specialist or non-acute hospitals

• Team visits taking place in paediatric hospitals

• Team visits (meeting the scope of NCAA) in response to pre-hospital cardiac arrests

Year Number of hospitals

participating in NCAA

Total number of admissions to

hospital

Total number of reported

in-hospital cardiac arrests

Total number of individuals

April 2019 – March 2020 175 13,989,599 13,211 12,682

April 2018 – March 2019 187 13,993,808 14,109 13,545

April 2017 – March 2018 183 13,823,521 15,981 15,413

April 2016 – March 2017 183 13,599,681 16,682 16,124

April 2015 – March 2016 188 12,775,043 16,969 16,347

Note: Number of hospitals participating in NCAA includes those submitting data for all or part of the specified period


3 © NCAA 2020

Incidence of in-hospital cardiac arrests attended by the team

Number of in-hospital cardiac arrests attended by the team

Rate of in-hospital cardiac arrests per 1000 hospital admissions


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Trends in incidence of in-hospital cardiac arrests attended

by the team

Number of in-hospital cardiac arrests attended by the team

Note: number of hospitals participating in NCAA has increased over time

Rate of in-hospital cardiac arrests per 1000 hospital admissions


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Patient characteristics

Age (years), n (%)

0-15 166 (1.3)

16-64 3,664 (27.7)

65-74 3,112 (23.6)

75-84 3,942 (29.8)

85+ 2,324 (17.6)

Missing 3 (0.0)

Mean (SD) 70.4 (16.4)

Median (IQR) 74 (62, 82)

Sex, n (%)

Female 5,226 (39.6)

Male 7,984 (60.4)

Missing 1 (0.0)

Reason for admission to/attendance at/visit to your hospital, n (%)

Patient - trauma 345 (2.6)

Patient - medical 11,136 (84.3)

Patient - elective/scheduled surgery 677 (5.1)

Patient - emergency/urgent surgery 779 (5.9)

Patient - obstetric 36 (0.3)

Outpatient 173 (1.3)

Staff 15 (0.1)

Visitor 47 (0.4)

Missing 3 (0.0)

IQR, interquartile range; SD, standard deviation.


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Trends in patient characteristics

Mean age

Sex: Male


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Reason for attendance: Medical


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Team visit characteristics

Number of days from admission to 2222 call, n (%)

0 3,842 (29.1)

1 2,329 (17.6)

2-7 4,263 (32.3)

8-30 2,340 (17.7)

>30 433 (3.3)

Missing 4 (0.0)

Mean (SD) 5.7 (12.0)

Median (IQR) 2 (0, 6)

Location of arrest, n (%)

Emergency department 1,397 (10.6)

Emergency admissions unit 933 (7.1)

Theatre & recovery 238 (1.8)

Imaging department 290 (2.2)

Cardiac catheter laboratory 599 (4.5)

Specialist treatment area 184 (1.4)

ICU or ICU/HDU 814 (6.2)

HDU 141 (1.1)

PICU 30 (0.2)

PHDU 10 (0.1)

Coronary care unit 1,301 (9.8)

Other intermediate care area 22 (0.2)

Obstetrics area 17 (0.1)

Ward 7,071 (53.5)

Other internal location 18 (0.1)

Clinic 45 (0.3)

Non-clinical area 101 (0.8)

Status at team arrival, n (%)

Dead - resuscitation stopped 110 (0.8)

Resuscitation ongoing 10,702 (81.0)

ROSC achieved before team arrival 1,536 (11.6)

Deteriorating (not yet arrested) 859 (6.5)

Missing 4 (0.0)

Presenting/first documented rhythm, n (%)

Shockable - VF 1,542 (11.7)

Shockable - VT 783 (5.9)

Shockable - unknown rhythm 69 (0.5)

Non-shockable - asystole 2,554 (19.3)

Non-shockable - PEA 6,811 (51.6)

Non-shockable - bradycardia 41 (0.3)

Non-shockable - unknown rhythm 254 (1.9)

Never determined 728 (5.5)

Unknown 429 (3.2)

HDU, high dependency unit; ICU, intensive care unit; IQR, interquartile range; PEA, pulseless electrical activity; PHDU, paediatric high dependency unit; PICU, paediatric intensive care unit; ROSC, return of spontaneous circulation; SD, standard deviation; VF, ventricular fibrillation; VT, ventricular tachycardia.


9 © NCAA 2020

Trends in team visit characteristics

Mean number of days from admission to 2222 call

Location of arrest: Ward


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Status at team arrival: Resuscitation ongoing

Presenting/first documented rhythm


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Outcomes

Reason resuscitation stopped at end of team visit, n (%)

Alive - ROSC > 20 minutes 6,911 (52.3)

Dead - ROSC < 20 minutes 822 (6.2)

Dead - no ROSC 4,589 (34.7)

Dead - DNACPR 338 (2.6)

Dead - futility 549 (4.2)

Missing 2 (0.0)

Post-arrest location, n (% of ROSC > 20 minutes)

Emergency admissions unit 195 (2.8)

ICU or ICU/HDU 2,692 (39.0)

HDU 117 (1.7)

PICU 36 (0.5)

PHDU 10 (0.1)

CCU 1,283 (18.6)

Other intermediate care area 11 (0.2)

Obstetrics area 4 (0.1)

Ward 1,473 (21.3)

Other internal location 6 (0.1)

Mortuary 772 (11.2)

Other hospital 283 (4.1)

Not in hospital 29 (0.4)

CPC at hospital discharge, n (% of adult survivors)

1 2,137 (71.4)

2 199 (6.7)

3 81 (2.7)

4 7 (0.2)

Missing 568 (19.0)

CPC, cerebral performance category; DNACPR, do not attempt cardiopulmonary resuscitation; HDU, high dependency unit; ICU, intensive care unit; PHDU, paediatric high dependency unit; PICU, paediatric intensive care unit; ROSC, return of spontaneous circulation.


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Outcome flow All percentages are reported as the percentage of all individuals (N=12,682).


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Trends in outcomes

Reason resuscitation stopped: ROSC > 20 minutes

Post-arrest location: ICU or ICU/HDU


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Survival to hospital discharge

CPC at hospital discharge (adult survivors)


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Outcomes by patient subgroups

ROSC > 20 minutes

Subgroup Number of in-hospital

cardiac arrests*

Number with ROSC > 20 min

Percentage (95% confidence interval)

Overall 13,209 6,911 52.3 (51.5, 53.2)

By presenting rhythm:

Shockable - VF/VT 2,324 1,768 76.1 (74.3, 77.8)

Non-shockable - asystole 2,554 809 31.7 (29.9, 33.5)

Non-shockable - PEA 6,811 3,300 48.5 (47.3, 49.6)

By age group (years):

0-15 166 108 65.1 (57.5, 71.9)

16-64 3,664 2,218 60.5 (58.9, 62.1)

65-74 3,112 1,690 54.3 (52.6, 56.0)

75-84 3,942 1,941 49.2 (47.7, 50.8)

85+ 2,324 954 41.0 (39.1, 43.1)

PEA, pulseless electrical activity; ROSC, return of spontaneous circulation; VF, ventricular fibrillation; VT, ventricular tachycardia.

* Excluding arrests missing reason resuscitation stopped (N=2).

Survival to hospital discharge

Subgroup Number of individuals*

Number of hospital survivors

Percentage (95% confidence interval)

Overall 12,654 3,025 23.9 (23.2, 24.7)

By presenting rhythm:

Shockable - VF/VT 2,101 1,064 50.6 (48.5, 52.8)

Non-shockable - asystole 2,484 287 11.6 (10.4, 12.9)

Non-shockable - PEA 6,586 1,021 15.5 (14.6, 16.4)

By age group (years):

0-15 156 87 55.8 (47.9, 63.3)

16-64 3,464 1,171 33.8 (32.2, 35.4)

65-74 2,967 703 23.7 (22.2, 25.3)

75-84 3,808 751 19.7 (18.5, 21.0)

85+ 2,258 313 13.9 (12.5, 15.3)

PEA, pulseless electrical activity; VF, ventricular fibrillation; VT, ventricular tachycardia.

* Excluding individuals still in hospital (N=26) or missing hospital survival (N=2).


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Trends in outcomes by patient subgroups

ROSC > 20 minutes by presenting/first documented rhythm

ROSC > 20 minutes by age group


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Survival to hospital discharge by presenting/first documented rhythm

Survival to hospital discharge by age group

Documents

Key statistics from the National Cardiac Arrest Audit