Clinical characteristics of acute poisoning-related in-hospital cardiac arrest: a single-center retrospective study
- 1Emergency Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- 2Wenzhou Key Laboratory of Emergency and Disaster Medicine, Wenzhou, China
Abstract
Background: Acute poisoning is a recognized special circumstance in cardiac arrest, yet data on acute poisoning-related in-hospital cardiac arrest (IHCA) remain limited. This study aimed to describe the toxicant spectrum, presentation-to-IHCA interval, pre-arrest physiological status, resuscitation characteristics, and hospital outcomes among patients with acute poisoning-related IHCA.
Methods: We performed a single-center retrospective descriptive study of consecutive emergency department presentations for acute poisoning between January 1, 2023 and January 1, 2026. Eligible presentations included patients who developed IHCA after hospital arrival and were treated with chest compressions, defibrillation, or both. We extracted toxicant categories, presentation-to-IHCA interval, the most recent documented pre-arrest assessment within 1 h before IHCA, resuscitation characteristics, and in-hospital outcomes.
Results: Among 2,016 consecutive presentations for acute poisoning, 16 index IHCA events occurred in 16 patients (0.79%). Pesticide exposure was identified in 12 cases, including bipyridyl herbicides in 6, organophosphate pesticides in 3, and other pesticides in 3. Non-pesticide toxicants included aconitine in 2 patients, a cardiac glycoside-containing plant in 1, and mixed antipsychotic drugs in 1. Twelve of 16 IHCA events occurred within 24 h of presentation. The median interval between the last documented pre-arrest assessment and IHCA onset was 11.0 min (IQR, 7.3–30.8; range, 2–53). Documented pre-arrest assessments showed abnormalities in consciousness and hemodynamic status. The median Glasgow Coma Scale score was 8 (IQR, 3–13.5), 9 patients had a score ≤ 8, and 6 required vasoactive support before arrest, of whom 4 remained hypotensive at the most recent assessment. Initial arrest rhythm was shockable in 2 patients, non-shockable in 9, and unknown in 5. Return of spontaneous circulation (ROSC) was achieved in 13 patients; 3 patients survived to discharge, and all survivors had favorable neurological status at discharge.
Conclusions: Acute poisoning-related IHCA was uncommon but associated with substantial mortality in this single-center descriptive cohort. Pesticide exposure predominated, most IHCA events occurred within 24 h of presentation, documented pre-arrest abnormalities were observed, and hospital survival remained poor despite frequent ROSC. These findings provide descriptive in-hospital data on a rare toxicological cardiac arrest subgroup and should not be interpreted as identifying predictors of IHCA.
Related
- Age-specific trends in poisoning-related out-of-hospital cardiac arrest in Japan: a retrospective nationwide registry study.
- Clinical characteristics, pathogen detection, and severity markers among children with acute respiratory infections during the COVID-19 restriction period: a retrospective hospital-based study
- Clinical and Microbiological Characteristics of Septic Arthritis in 25 Adults at a Tertiary Hospital in Cambodia: A Single-Center Retrospective Case Series
- Clinical Characteristics and In-Hospital Course of Symptomatic Intracranial Hemorrhage After Intravenous Alteplase in Older Adults with Acute Ischemic Stroke: A Retrospective Cohort Study
- Age-related clinical characteristics of respiratory syncytial virus infection in hospitalized children: a retrospective study
BibTeX
@article{ye2026clinical,
title = {{Clinical characteristics of acute poisoning-related in-hospital cardiac arrest: a single-center retrospective study}},
author = {Shuhao Ye and Jiujiu Gui and Pinxuan Zhou and Nanwei Lin and Zhongqiu Lu},
journal = {BMC Emergency Medicine},
year = {2026},
month = jul,
doi = {10.1186/s12873-026-01703-8},
url = {https://doi.org/10.1186/s12873-026-01703-8},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Clinical characteristics of acute poisoning-related in-hospital cardiac arrest: a single-center retrospective study
AU - Shuhao Ye
AU - Jiujiu Gui
AU - Pinxuan Zhou
AU - Nanwei Lin
AU - Zhongqiu Lu
PY - 2026
DA - 2026/07/30
JO - BMC Emergency Medicine
DO - 10.1186/s12873-026-01703-8
UR - https://doi.org/10.1186/s12873-026-01703-8
AB - Background: Acute poisoning is a recognized special circumstance in cardiac arrest, yet data on acute poisoning-related in-hospital cardiac arrest (IHCA) remain limited. This study aimed to describe the toxicant spectrum, presentation-to-IHCA interval, pre-arrest physiological status, resuscitation characteristics, and hospital outcomes among patients with acute poisoning-related IHCA. Methods: We performed a single-center retrospective descriptive study of consecutive emergency department presentations for acute poisoning between January 1, 2023 and January 1, 2026. Eligible presentations included patients who developed IHCA after hospital arrival and were treated with chest compressions, defibrillation, or both. We extracted toxicant categories, presentation-to-IHCA interval, the most recent documented pre-arrest assessment within 1 h before IHCA, resuscitation characteristics, and in-hospital outcomes. Results: Among 2,016 consecutive presentations for acute poisoning, 16 index IHCA events occurred in 16 patients (0.79%). Pesticide exposure was identified in 12 cases, including bipyridyl herbicides in 6, organophosphate pesticides in 3, and other pesticides in 3. Non-pesticide toxicants included aconitine in 2 patients, a cardiac glycoside-containing plant in 1, and mixed antipsychotic drugs in 1. Twelve of 16 IHCA events occurred within 24 h of presentation. The median interval between the last documented pre-arrest assessment and IHCA onset was 11.0 min (IQR, 7.3–30.8; range, 2–53). Documented pre-arrest assessments showed abnormalities in consciousness and hemodynamic status. The median Glasgow Coma Scale score was 8 (IQR, 3–13.5), 9 patients had a score ≤ 8, and 6 required vasoactive support before arrest, of whom 4 remained hypotensive at the most recent assessment. Initial arrest rhythm was shockable in 2 patients, non-shockable in 9, and unknown in 5. Return of spontaneous circulation (ROSC) was achieved in 13 patients; 3 patients survived to discharge, and all survivors had favorable neurological status at discharge. Conclusions: Acute poisoning-related IHCA was uncommon but associated with substantial mortality in this single-center descriptive cohort. Pesticide exposure predominated, most IHCA events occurred within 24 h of presentation, documented pre-arrest abnormalities were observed, and hospital survival remained poor despite frequent ROSC. These findings provide descriptive in-hospital data on a rare toxicological cardiac arrest subgroup and should not be interpreted as identifying predictors of IHCA.
SN - 1471-227X
ER -