Abstract Body: Introduction/Background
Computed tomography (CT) imaging is a promising method for diagnosing patients after return of spontaneous circulation (ROSC) from cardiac arrest. CT information could alter management, improving patient outcomes. There are data supporting use after out-of-hospital arrests, but use and impact of CT imaging after in-hospital-cardiac arrest (IHCA) has not been investigated.
Research Question/Hypothesis
We hypothesize that CT imaging will identify acute pathology, resulting in a change in management.
Goals/Aims
Our aim is to describe the rates of use, findings, and consequences of CT imaging after IHCA.
Methods/Approach
We screened for the first IHCA on admission between 1/26 2023, and 1/302024 at 3 hospitals. Patients 18 years of age or older who achieved ROSC were included. Information was collected on demographics, type of imaging performed, imaging findings, and whether the findings acutely changed management. A change in management was defined as a subsequent change in medications, procedures, or consultations that would not have otherwise occurred and was specifically performed to reverse, mitigate, or treat the imaging finding, based on review of chart documentation by critical care fellows and medicine residents. Results are reported as counts and percentages.
Results
We screened 638 IHCA at 3 hospitals. Of the 201 patients meeting inclusion criteria, 72 (35.8%) died within 24 hours after ROSC. Of those who survived 24 hours, 58 of 129 (45.0%) received CT imaging in the 48 hours after ROSC, 53 (41.1%) received a head CT, 26 (20.2%) received a chest CT, 19 (14.7%) received an abdomen/pelvis CT, and 4 (3.1%) received a CT that was not head, chest, or abdomen/pelvis. The most common findings were ischemic stroke (15), pulmonary airspace opacities (23), and pleural effusion (15). An acute finding (previously unknown) was identified in 32 of 58 scans (55.2%), and there was an acute change in management because of the acute finding in 21 (65.6%) of those patients. For 8 patients (13.8%), the scan identified an acute finding thought to have contributed to the cardiac arrest. Of the 58 patients who received CT imaging, 2 of them (3.4%) suffered cardiac arrest while receiving the CT scan.
Conclusions
CT imaging within 48 hours after IHCA frequently identified acute pathology, resulting in a change in management. Complications were seen, although we do not know if these were a result of the CT imaging, related transportation, or other causes.