Table 2. Patient, Hospital, and Event Characteristics Among Patients With In-Hospital Cardiac Arrest Without vs With Intubation in the First 15 Minutes of Resuscitation in the Matched Cohorta.
| Characteristic | Patients, No. (%) | Standardized Difference | |
|---|---|---|---|
| No Intubation (n = 43 314) | Intubation (n = 43 314) | ||
| Patient Characteristics | |||
| Demographic | |||
| Age, median (IQR), y | 70 (58-79) | 70 (58-80) | .014 |
| Sex | |||
| Male | 25 332 (58) | 25 486 (59) | .007 |
| Female | 17 982 (42) | 17 828 (41) | .007 |
| Race | |||
| White | 30 547 (71) | 30 713 (71) | .008 |
| Black | 8837 (20) | 8710 (20) | .007 |
| Other | 1361 (3) | 1321 (3) | .005 |
| Not reported | 2569 (6) | 2570 (6) | <.001 |
| Illness category | |||
| Medical | |||
| Cardiac | 15 779 (36) | 15 716 (36) | .003 |
| Noncardiac | 19 979 (46) | 20 017 (46) | .002 |
| Surgical | |||
| Cardiac | 2274 (5) | 2197 (5) | .008 |
| Noncardiacb | 4623 (11) | 4708 (11) | .006 |
| Trauma | 659 (2) | 676 (2) | .003 |
| Preexisting conditionc | |||
| Cardiac | |||
| History of myocardial infarction | 7477 (17) | 7370 (17) | .007 |
| Myocardial infarction this admission | 6786 (16) | 6697 (15) | .006 |
| History of heart failure | 10 186 (24) | 10 170 (23) | .001 |
| Heart failure this admission | 7852 (18) | 7947 (18) | .006 |
| Noncardiac | |||
| Respiratory insufficiency | 14 822 (34) | 14 845 (34) | .001 |
| Diabetes mellitus | 14 264 (33) | 14 334 (33) | .003 |
| Renal insufficiency | 14 893 (34) | 14 739 (34) | .007 |
| Metastatic or hematologic malignancy | 5579 (13) | 5663 (13) | .006 |
| Hypotension or hypoperfusion | 8659 (20) | 8741 (20) | .005 |
| Pneumonia | 5381 (12) | 5351 (12) | .002 |
| Baseline depression in CNS function | 4629 (11) | 4636 (11) | .001 |
| Metabolic or electrolyte abnormality | 6300 (15) | 6306 (15) | <.001 |
| Septicemia | 5598 (13) | 5707 (13) | .007 |
| Acute CNS nonstroke event | 2708 (6) | 2756 (6) | .005 |
| Hepatic insufficiency | 2837 (7) | 2841 (7) | <.001 |
| Acute stroke | 1639 (4) | 1652 (4) | .002 |
| Major trauma | 962 (2) | 954 (2) | .001 |
| Hospital Characteristics | |||
| Bed size, No. | |||
| 1-249 | 8132 (19) | 8016 (19) | .007 |
| 250-499 | 17 367 (40) | 17 444 (40) | .004 |
| ≥500 | 17 815 (41) | 17 854 (41) | .002 |
| Teaching status | |||
| Major | 14 747 (34) | 14 609 (34) | .007 |
| Minor | 13 252 (31) | 13 357 (31) | .005 |
| Nonteaching | 15 315 (35) | 15 348 (35) | .002 |
| Ownership | |||
| Military | 905 (2) | 928 (2) | .004 |
| Nonprofit | 31 189 (72) | 31 195 (72) | <.001 |
| Government | 6444 (15) | 6385 (15) | .004 |
| Private | 4776 (11) | 4806 (11) | .002 |
| Location | |||
| Rural | 2342 (5) | 2348 (5) | .001 |
| Urban | 40 972 (95) | 40 966 (95) | .001 |
| Geographical location | |||
| Northeast | 6032 (14) | 6077 (14) | .003 |
| Southeast | 13 184 (30) | 13 123 (30) | .003 |
| Midwest | 9090 (21) | 9160 (21) | .004 |
| South central | 8977 (21) | 8898 (21) | .005 |
| West | 6031 (14) | 6056 (14) | .002 |
| In-Hospital Cardiac Arrest Characteristics | |||
| Year of cardiac arrest | |||
| 2000-2002 | 4319 (10) | 4480 (10) | .012 |
| 2003-2004 | 6783 (16) | 6642 (15) | .009 |
| 2005-2006 | 6691 (15) | 6824 (16) | .008 |
| 2007-2008 | 6484 (15) | 6486 (15) | <.001 |
| 2009-2010 | 5837 (13) | 5709 (13) | .009 |
| 2011-2012 | 5965 (14) | 6030 (14) | .004 |
| 2013-2014 | 7235 (17) | 7143 (16) | .006 |
| In place at time of cardiac arrest | |||
| Noninvasive assisted ventilation | 2296 (5) | 2377 (5) | .008 |
| Dialysisd | 1185 (3) | 1176 (3) | .001 |
| Implantable cardiac defibrillator | 827 (2) | 780 (2) | .008 |
| Intra-arterial catheter | 1455 (3) | 1417 (3) | .005 |
| Electrocardiogram | 31 224 (72) | 31 059 (72) | .008 |
| Pulse oximeter | 23 623 (55) | 23 524 (54) | .005 |
| Vasoactive agentse | 5430 (13) | 5426 (13) | <.001 |
| Antiarrhythmic agentsf | 1123 (3) | 1093 (3) | .004 |
| Location | |||
| Emergency department | 4422 (10) | 4546 (11) | .009 |
| Floor with telemetry | 9342 (22) | 9373 (22) | .002 |
| Floor without telemetry | 12 263 (28) | 12 331 (28) | .003 |
| Intensive care unit | 13 556 (31) | 13 384 (31) | .009 |
| OR, PACU, or interventional unit | 2585 (6) | 2550 (6) | .003 |
| Otherg | 1146 (3) | 1130 (3) | .002 |
| Time of day | |||
| Day, 7:00 AM to 10:59 PM | 28 953 (67) | 28 878 (67) | .004 |
| Night, 11:00 PM to 6:59 AM | 14 361 (33) | 14 436 (33) | .004 |
| Day | |||
| Weekday, Monday 7 AM to Friday 11 PM | 29 809 (69) | 28 886 (69) | .004 |
| Weekend, Friday 11 PM to Monday 7 AM | 13 505 (31) | 13 428 (31) | .004 |
| Hospital-wide cardiac arrest response activated | 36 562 (84) | 36 529 (84) | .002 |
| Witnessed | 32 884 (76) | 32 835 (76) | .003 |
| First documented pulseless rhythm | |||
| Asystole | 16 324 (38) | 16 574 (38) | .012 |
| Pulseless electrical activity | 20 344 (47) | 20 065 (46) | .013 |
| Ventricular fibrillation | 4478 (10) | 4501 (10) | .002 |
| Pulseless ventricular tachycardia | 2168 (5) | 2174 (5) | .001 |
| Time to compressions, min | |||
| 0 | 39 465 (91) | 39 537 (91) | .006 |
| 1 | 1963 (5) | 1931 (4) | .004 |
| ≥2 | 1886 (4) | 1846 (4) | .005 |
| Epinephrine administered before matching | 23 084 (53) | 23 226 (54) | .007 |
| Time to epinephrine administration, median (IQR), min | 1 (1-3) | 1 (1-3) | .027 |
| Defibrillation before matchingh | 3895 (59) | 3859 (58) | .016 |
| Time to defibrillation, median (IQR), min | 1 (0-2) | 1 (0-2) | .050 |
Abbreviations: CNS, central nervous system; IQR, interquartile range; OR, operating room; PACU, postanesthesia care unit.
Patients being intubated at any given minute (from 0-15 minutes; intubation group) were matched with patients at risk of being intubated within the same minute (ie, still receiving resuscitation; no intubation group) based on a time-dependent propensity score calculated from multiple patient, event, and hospital characteristics.
Includes patients with an obstetric admission (n = 110).
See eTable 1 in the Supplement for definitions of preexisting conditions.
Hemodialysis or peritoneal dialysis, continuous arteriovenous dialysis, or venovenous hemofiltration or dialysis.
Dobutamine, dopamine (>3 μg/kg/min), epinephrine, nitroglycerin, norepinephrine, phenylephrine, vasopressin, and/or “other vasoactive agent(s).”
Continuous infusion of amiodarone, lidocaine, procainamide, and/or “other antiarrhythmic(s).”
Ambulatory and outpatient areas; delivery suite; rehabilitation, skilled nursing, and mental health facilities; same-day surgical areas; and “other.”
Includes only patients with a first documented pulseless rhythm of pulseless ventricular tachycardia or ventricular fibrillation.