Diverging Trends in Treated In-Hospital Cardiac Arrest in Intensive Care Units and General Wards Using Location-Specific Patient-Days
- 1Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Republic of Korea
- 2Department of Critical Care Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Republic of Korea
- 3Clinical Quality Improvement Team, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Republic of Korea
Abstract
Background/Objectives: Hospital-level incidence estimates may obscure differences between intensive care units (ICUs) and general wards. We compared temporal trends in treated adult in-hospital cardiac arrest (IHCA) using location-specific patient-days. Methods: This retrospective study covered January 2016 to June 2026 at a South Korean teaching hospital. Monthly treated IHCA counts were modeled using negative binomial regression with patient-days as an offset, a setting × time interaction, and adjustment for the COVID-19 period and seasonality. Calendar-month score-based HAC analyses assessed robustness to serial correlation. January–March 2022 was excluded because arrest location was unavailable. Results: The incidence cohort comprised 1712 events: 1373 in ICUs and 339 in general wards. The combined rate was 1.06 per 1000 patient-days. The setting × time interaction was significant (monthly IRR 0.9843, model-based 95% CI 0.9768–0.9918), corresponding to a 17.3% annual decrease in the ICU-to-ward rate ratio. Calendar-month score-based HAC confidence intervals also excluded 1. ICU incidence declined (monthly IRR 0.9875, 95% CI 0.9825–0.9925), whereas the general-ward model showed no statistically significant temporal trend (IRR 1.0033, 95% CI 0.9975–1.0090; p = 0.263). Conclusions: Location-specific patient-day denominators identified different temporal trajectories in treated IHCA. These findings describe observed treated events and do not establish changes in underlying arrest risk or resuscitation performance.
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BibTeX
@article{lee2026diverging,
title = {{Diverging Trends in Treated In-Hospital Cardiac Arrest in Intensive Care Units and General Wards Using Location-Specific Patient-Days}},
author = {Shinhwan Lee and Kyung Hun Nam and Hang A. Park and Hye Ji Park and Yoo Ri Roh and Choung Ah Lee},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207881},
url = {https://www.mdpi.com/2077-0383/15/20/7881},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Diverging Trends in Treated In-Hospital Cardiac Arrest in Intensive Care Units and General Wards Using Location-Specific Patient-Days
AU - Shinhwan Lee
AU - Kyung Hun Nam
AU - Hang A. Park
AU - Hye Ji Park
AU - Yoo Ri Roh
AU - Choung Ah Lee
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207881
UR - https://www.mdpi.com/2077-0383/15/20/7881
AB - Background/Objectives: Hospital-level incidence estimates may obscure differences between intensive care units (ICUs) and general wards. We compared temporal trends in treated adult in-hospital cardiac arrest (IHCA) using location-specific patient-days. Methods: This retrospective study covered January 2016 to June 2026 at a South Korean teaching hospital. Monthly treated IHCA counts were modeled using negative binomial regression with patient-days as an offset, a setting × time interaction, and adjustment for the COVID-19 period and seasonality. Calendar-month score-based HAC analyses assessed robustness to serial correlation. January–March 2022 was excluded because arrest location was unavailable. Results: The incidence cohort comprised 1712 events: 1373 in ICUs and 339 in general wards. The combined rate was 1.06 per 1000 patient-days. The setting × time interaction was significant (monthly IRR 0.9843, model-based 95% CI 0.9768–0.9918), corresponding to a 17.3% annual decrease in the ICU-to-ward rate ratio. Calendar-month score-based HAC confidence intervals also excluded 1. ICU incidence declined (monthly IRR 0.9875, 95% CI 0.9825–0.9925), whereas the general-ward model showed no statistically significant temporal trend (IRR 1.0033, 95% CI 0.9975–1.0090; p = 0.263). Conclusions: Location-specific patient-day denominators identified different temporal trajectories in treated IHCA. These findings describe observed treated events and do not establish changes in underlying arrest risk or resuscitation performance.
SN - 2077-0383
ER -