Survival to Discharge Rate and Favorable Neurological Outcome Related to Gender, Duration of Resuscitation and First Document of Patients In-Hospital Cardiac Arrest: A Systematic Meta-Analysis

OBJECTIVE: To investigate the relationship between outcomes and demographic-clinical variables in in-hospital cardiac arrest (IHCA). METHODS: The Medline database was searched along with Google Scholar, Scopus, Web of Science, and Persian language database without time limitation until January 6(th), 2020. The inclusion criteria included papers published in journals or presented in English and Persian congress that reported the IHCA outcomes based on the Utstein criterion. All the descriptive, cross-sectional, and cohort studies on CPR were covered based on inclusion and exclusion criteria. Primary checks covered titles and abstracts followed by a full-text check of the remaining papers from the first screening stage. Data analysis was done using comprehensive meta-analysis (CMA) software version 2.0. The finding’s heterogeneity was checked using Q and Cochran tests with heterogeneity >50% and the random-effects model was used to estimate survival and favorable neurological outcome (FNO) in the analysis. To detect the publication bias of studies, the subgroup test, meta-regression test, sensitivity analysis test, funnel plot, and Eagger’s regression test were used. RESULTS: Survival to discharge was 19.1% (95% CI=16.8-21.7) and FNO in the survived to discharge cases was 68.1% (95% CI=55.8-78.3). Survival to discharge and FNO were notably higher in men, CPR duration <15min, and shockable dysrhythmias. CONCLUSION: IHCA outcomes are poor in developing countries. The outcomes of IHCA in terms of gender were inconsistent with the result reported by other meta-analyses.