# Nationwide analysis of mortality predictors following in-hospital cardiac arrest in older Thai adults, 2016–2024

## TL;DR

This study analyzed CPR trends and survival factors in older Thai adults who experienced in-hospital cardiac arrest from 2016 to 2024.

## Contribution

The paper provides a nationwide analysis of mortality predictors in older Thai adults following in-hospital cardiac arrest using national health data.

## Key findings

- CPR rates were higher in males and older adults but declined in 2020.
- Survival to hospital discharge improved to 33%, with male sex and older age linked to higher mortality.
- Cardiovascular disease was the most common diagnosis, and procedures like extracorporeal membrane oxygenation increased mortality risk.

## Abstract

•CPR rates peaked in males & older adults but dropped in 2020.•Survival improved to 33%, better than previous Thai data.•Mortality associated with sex, age, rhythm type, diagnoses, and interventions.

CPR rates peaked in males & older adults but dropped in 2020.

Survival improved to 33%, better than previous Thai data.

Mortality associated with sex, age, rhythm type, diagnoses, and interventions.

In-hospital cardiac arrest (IHCA) is common among older adults, but recent detailed studies in Thailand on trends or factors related to hospital mortality in this group are lacking. This study aimed to analyze trends in in-hospital cardiopulmonary resuscitation (CPR) among older adults, their outcomes, and survival factors to hospital discharge using the national database from 2016 to 2024.

National data from Thailand’s National Health Security Office covered all inpatients aged ≥60 years who received IHCA during 2016–2024, defined by the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Thai Modification (ICD-10-TM) based on ICD-9-99.6. Retrospective data from discharge summaries examined age-adjusted prevalence and survival rates of older CPR patients, normalized to 100,000 Thais, focusing on survival after CPR and associated factors of discharge mortality.

A total of 190,271 older patients received CPR. The most common primary diagnosis was cardiovascular disease (41.4%). Age-adjusted CPR rates were 221/100,000 males and 147/100,000 females. The survival rate to hospital discharge was 33%, with age-adjusted rates of 72/100,000 males and 50/100,000 females. Mortality was linked to male gender (adjusted odds ratio [AOR] 1.06), older age (AOR 70–79: 1.11; over 80: 1.30), specific diagnoses, arrest types (AOR for non-shockable 1.21; shockable 0.39–0.69), and procedures like coronary artery bypass Grafting (AOR 0.21), intra-aortic balloon pump (AOR 2.05), pacemaker (AOR 0.24), extracorporeal membrane oxygenation (AOR 5.18), and mechanical ventilation ≥96 h (AOR 0.88).

CPR rates were higher in older males than in females. Cardiovascular disease was the main primary diagnosis. Overall survival to hospital discharge was about 33%. Mortality was linked to male sex, older age, cardiac rhythm types, diagnoses, and procedures.