The incidence and characteristics of bacteremia in cardiac arrest

Heart Lung. 2022 Mar-Apr:52:106-109. doi: 10.1016/j.hrtlng.2021.12.001. Epub 2021 Dec 23.

Abstract

Background: Despite improvements in both preventative and post-event care, cardiac arrest still occurs frequently with high morbidity and mortality. Bacteremia is a potential cause or complication of cardiac arrest that has received increasing notoriety in recent years.

Objectives: To identify the incidence of and predictive factors for bacteremia in both inside and outside of hospital cardiac arrest patients.

Methods: Retrospective, single centered, cohort study conducted at an academic medical center. Patients 18 years of age or older with cardiac arrest and blood cultures drawn within 24 h of the event were included.

Results: Two-hundred sixty-three cardiac arrest patients were included, of which forty-three patients (16.3%) were bacteremic. Patients with bacteremia had higher rates of home parenteral nutrition and a history of known infection before cardiac arrest. Bacteremic patients had a higher blood urea nitrogen (30 mg/dL vs. 23, p = 0.02), serum creatinine (2.40 mg/dL vs. 1.70, p = 0.05), and troponin (0.39 ng/mL vs. 0.12, p = 0.03) compared with the non-bacteremic group. There were no differences in duration of mechanical ventilation, hospital length of stay or ICU length of stay. Mortality at 28-days was higher in the bacteremic group (79%) compared to the non-bacteremic group (60.9%, p = 0.02). No factors associated with bacteremia were identified.

Conclusion: Bacteremia was observed in 16.3% of patients, with significant differences between the bacteremic and non-bacteremic group regarding home parenteral nutrition and known infection before the event, cardiac arrest characteristics (blood urea nitrogen, serum creatinine, and troponin), and 28-day mortality.

Keywords: Bacteremia; Cardiac arrest; Incident event; Infection; Risk factors.

MeSH terms

  • Adult
  • Bacteremia* / epidemiology
  • Creatinine
  • Heart Arrest* / complications
  • Heart Arrest* / epidemiology
  • Humans
  • Incidence
  • Retrospective Studies
  • Risk Factors
  • Troponin

Substances

  • Troponin
  • Creatinine