Association between outpatient polypharmacy with return of spontaneous circulation and in-hospital mortality after in-hospital cardiac arrest

• Grant number: 22/05347-8
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: August 01, 2022
• End date: July 31, 2024
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Paula Schmidt Azevedo Gaiolla
• Grantee: Gustavo Martins Ferreira
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

In-hospital cardiorespiratory arrest (IHCA) has a high prevalence worldwide, as well as a high mortality rate, being one of the main causes of death among hospitalized patients. In addition, only 20% to 25% of these patients receive hospital discharge, and even thought may have serious sequelae. In this scenario, some drugs, such as opioids and sedatives, are predictors of IHCA and could worse its prognosis. However, there are no study that evaluated the relationship between polypharmacy and outcomes after IHCA. Thus, this study aims to assess whether the outpatient use of polypharmacy is associated with return of spontaneous circulation (ROSC) and in-hospital mortality in patients with IHCA. In this retrospective observational study, all patients over 18 years old and who had IHCA at Hospital das Clínicas da Faculdade de Medicina de Botucatu (HCFMB) and were supported by the Rapid Response Team (RRT) will be included. We estimate to include approximately 200 patients. Demographic, clinical and laboratory data will be collected from the electronic medical record and the TRR attendance records. Polypharmacy will be defined as the outpatient use of 5 or more medications. The main outcomes will be in-hospital mortality and ROSC. When comparing groups with data that are normally distributed, we will use Student's t test. When comparing groups with data that are not normally distributed, we will use Mann-Whittney. Categorical variables will be compared with Chi-square test or Fisher's Exact test. We will also use multivariate logistic regression. The significance level adopted will be 5%.(AU)