key statistics from the national cardiac arrest audit
TRANSCRIPT
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
Key Statistics from the National Cardiac Arrest Audit 2019/20
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
Key Statistics from the National Cardiac Arrest Audit 2019/20
4 © NCAA 2020
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
Key Statistics from the National Cardiac Arrest Audit 2019/20
5 © NCAA 2020
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.
Key Statistics from the National Cardiac Arrest Audit 2019/20
6 © NCAA 2020
Trends in patient characteristics
Mean age
Sex: Male
Key Statistics from the National Cardiac Arrest Audit 2019/20
7 © NCAA 2020
Reason for attendance: Medical
Key Statistics from the National Cardiac Arrest Audit 2019/20
8 © NCAA 2020
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.
Key Statistics from the National Cardiac Arrest Audit 2019/20
9 © NCAA 2020
Trends in team visit characteristics
Mean number of days from admission to 2222 call
Location of arrest: Ward
Key Statistics from the National Cardiac Arrest Audit 2019/20
10 © NCAA 2020
Status at team arrival: Resuscitation ongoing
Presenting/first documented rhythm
Key Statistics from the National Cardiac Arrest Audit 2019/20
11 © NCAA 2020
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.
Key Statistics from the National Cardiac Arrest Audit 2019/20
12 © NCAA 2020
Outcome flow All percentages are reported as the percentage of all individuals (N=12,682).
Key Statistics from the National Cardiac Arrest Audit 2019/20
13 © NCAA 2020
Trends in outcomes
Reason resuscitation stopped: ROSC > 20 minutes
Post-arrest location: ICU or ICU/HDU
Key Statistics from the National Cardiac Arrest Audit 2019/20
14 © NCAA 2020
Survival to hospital discharge
CPC at hospital discharge (adult survivors)
Key Statistics from the National Cardiac Arrest Audit 2019/20
15 © NCAA 2020
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).
Key Statistics from the National Cardiac Arrest Audit 2019/20
16 © NCAA 2020
Trends in outcomes by patient subgroups
ROSC > 20 minutes by presenting/first documented rhythm
ROSC > 20 minutes by age group
Key Statistics from the National Cardiac Arrest Audit 2019/20
17 © NCAA 2020
Survival to hospital discharge by presenting/first documented rhythm
Survival to hospital discharge by age group