Evaluation of the blue code system established in the health campus of a university hospital
Yıl: 2021 Cilt: 21 Sayı: 1 Sayfa Aralığı: 14 - 19 Metin Dili: İngilizce DOI: 10.4103/2452-2473.301912 İndeks Tarihi: 17-07-2022
Evaluation of the blue code system established in the health campus of a university hospital
Öz: OBJECTIVE: We report the hospital outcomes after implementing the blue code system in our
hospital and health campus. We also aimed to determine factors related to mortality.
METHODS: This is a retrospective observational study of the patients who received cardiopulmonary
resuscitation (CPR). All blue code calls for all age groups between March 15, 2013, and April 30,
2015 were analyzed. Logistic regression analysis was performed to find independent predictors of
in-hospital mortality.
RESULTS: A total of 155 patients from the blue code calls were evaluated. Return of spontaneous
circulation was achieved in 45.5% of patients, and 54.8% of the patients had died at the end of the
CPR. The hospital discharge rate was 20%. Of all patients, 65% were adults with a survival rate of
7.9%, whereas pediatric patients had a 44.2% survival rate. Asystole and pulseless electrical activity
were the predominant electrocardiography rhythms in 92.4% of patients. The comparison of survivors
and nonsurvivors revealed that nonsurvivors were older, had more cancer as the comorbidity, had
a more cardiac arrest, and sepsis as the underlying cause and had >20 min of CPR. The logistic
regression analysis demonstrated the independent risk factors for mortality as arrest at a hospital
ward, and sepsis as the underlying cause and being adult patient.
CONCLUSION: The performance of the blue code system should be evaluated periodically. Every
effort should be made to prevent unexpected cardiac arrests and increase hospital discharge with
good neurologic outcomes.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Adabag AS, Luepker RV, Roger VL, Gersh BJ. Sudden cardiac death: Epidemiology and risk factors. Nat Rev Cardiol 2010;7:216‑25.
- 2. Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed‑chest cardiac massage. JAMA 1960;173:1064‑7.
- 3. Cooper S, Cade J. Predicting survival, in‑hospital cardiac arrests: Resuscitation survival variables and training effectiveness. Resuscitation 1997;35:17‑22.
- 4. Cohn AC, Wilson WM, Yan B, Joshi SB, Heily M, Morley P, et al. Analysis of clinical outcomes following in‑hospital adult cardiac arrest. Intern Med J. 2007;34:398‑402.
- 5. Chan PS, McNally B, Tang F, Kellermann A, CARES Surveillance Group. Recent trends in survival from out‑of‑hospital cardiac arrest in the United States. Circulation 2014;130:1876‑82.
- 6. Wong MK, Morrison LJ, Qiu F, Austin PC, Cheskes S, Dorian P, et al. Trends in short‑and long‑term survival among out‑of‑hospital cardiac arrest patients alive at hospital arrival. Circulation 2014;130:1883‑90.
- 7. Brindley PG, Markland DM, Mayers I, Kutsogiannis DJ. Predictors of survival following in‑hospital adult cardiopulmonary resuscitation. CMAJ 2002;167:343‑8.
- 8. Nadkarni VM, Larkin GL, Peberdy MA, Carey SM, Kaye W, Mancini ME, et al. First documented rhythm and clinical outcome from in‑hospital cardiac arrest among children and adults. JAMA 2006;295:50‑7.
- 9. Herlitz J, Bång A, Alsén B, Aune S. Characteristics and outcome among patients suffering from in hospital cardiac arrest in relation to whether the arrest took place during office hours. Resuscitation 2002;53:127‑33.
- 10. Matot I, Shleifer A, Hersch M, Lotan C, Weiniger CF, Dror Y, et al. In‑hospital cardiac arrest: Is outcome related to the time of arrest? Resuscitation 2006;71:56‑64.
- 11. Peberdy MA, Ornato JP, Larkin GL, Braithwaite RS, Kashner TM, Carey SM, et al. Survival from in‑hospital cardiac arrest during nights and weekends. JAMA 2008;299:785‑92.
- 12. Hillman K, Chen J, Cretikos M, Bellomo R, Brown D, Doig G, et al. Introduction of the medical emergency team (MET) system: A cluster‑randomised controlled trial. Lancet 2005;365:2091‑7.
- 13. Chan PS, Khalid A, Longmore LS, Berg RA, Kosiborod M, Spertus JA. Hospital‑wide code rates and mortality before and after implementation of a rapid response team. JAMA 2008;300:2506‑13.
- 14. Topeli Iskit A. (Danisman Cakır B). Evaluation of the process and outcome of blue code procedure developed for cardiopulmonary arrest in Hacettepe University Sihhiye campus. Ankara: HU Saglik Bilimleri Enstitusu Epidemiyoloji Yuksek Lisans Tezi; 2016.
- 15. Kendirli T, Erkek N, Koroglu T, Yildizdas D, Bayrakci B, Guzel A, et al. Cardiopulmonary resuscitation in children with in‑hospital and out‑of‑hospital cardiopulmonary arrest: Multicenter study from Turkey. Pediatr Emer Care 2015;31:748‑52.
- 16. Nolan JP, Soar J, Smith GB, Gwinnutt C, Parrott F, Power S, et al. Incidence and outcome of in‑hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit. Resuscitation 2014;85:987‑92.
- 17. Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, et al. Global, regional, and national sepsis incidence and mortality, 1990‑2017: Analysis for the Global Burden of Disease Study. Lancet 2020;395:200‑11.
- 18. Nishijima I, Oyadomari S, Maedomari S, Toma R, Igei C, Kobata S, et al. Use of a modified early warning score system to reduce the rate of in‑hospital cardiac arrest. J Intensive Care 2016;4:12.
- 19. Mathukia C, Fan W, Vadyak K, Biege C, Krishnamurthy M. Modified early warning system improves patient safety and clinical outcomes in an academic community hospital. J Community Hosp Intern Med Perspect 2015;5:26716.
- 20. Tanriover Durusu M, Yildirim G, Kehya E, Erdogan O, Nacar D, et al. Does the implementation of modified early warning scores spare workforce by decreasing the frequency of nurse assessments? Acta Medica (Hacettepe) 2014;3:80‑83.
- 21. Durusu Tanrıöver M, Halaçlı B, Sait B, Öcal S, Topeli A. Daily surveillance with early warning scores help predicthospital mortality in medical wards. Turk J Med Sci 2016;46:1786‑91.
- 22. Buist MD, Moore GE, Bernard SA, Waxman BP, Anderson JN, Nguyen TV. Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: Preliminary study. BMJ 2002;324:387‑90.
- 23. Beitler JR, Link N, Bails DB, Hurdle K, Chong DH. Reduction in hospital‑wide mortality after implementation of a rapid response team: A long‑term cohort study. Crit Care 2011;15:R269.
- 24. Jung B, Daurat A, De Jong A, Chanques G, Mahul M, Monnin M, et al. Rapid response team and hospital mortality in hospitalized patients. Intensive Care Med 2016;42:494‑504.
- 25. Singh S, Namrata, Grewal A, Gautam PL, Luthra N, Tanwar G, et al. Evaluation of cardiopulmonary resuscitation (CPR) for patient outcomes and their predictors. J Clin Diagn Res 2016;10:UC01‑4.
- 26. Agarwal DA, Hess EP, Atkinson EJ, White RD. Ventricular fibrillation in Rochester, Minnesota: Experience over 18 years. Resuscitation 2009;80:1253‑8.
- 27. Gülaçtı U, Celik M, Akçay S, Erdoğan MO, Ustün C. Initial results of code blue emergency call system: First experience in Turkey. Anadolu Kardiyol Derg 2014;14:486‑7.
- 28. Cicekci F, Atici SS. The evaluation of the results of cardiopulmoner resusitation associated with code-blue. Genel Tip Derg 2013;23:70‑76.
- 29. Yilmaz S, Omurlu IK. Survival after cardiopulmonary arrest in a tertiary care hospital in Turkey. Ann Saudi Med 2019;39:92‑9.
| APA | Topeli A, CAKIR B (2021). Evaluation of the blue code system established in the health campus of a university hospital. , 14 - 19. 10.4103/2452-2473.301912 |
| Chicago | Topeli Arzu,CAKIR BANU Evaluation of the blue code system established in the health campus of a university hospital. (2021): 14 - 19. 10.4103/2452-2473.301912 |
| MLA | Topeli Arzu,CAKIR BANU Evaluation of the blue code system established in the health campus of a university hospital. , 2021, ss.14 - 19. 10.4103/2452-2473.301912 |
| AMA | Topeli A,CAKIR B Evaluation of the blue code system established in the health campus of a university hospital. . 2021; 14 - 19. 10.4103/2452-2473.301912 |
| Vancouver | Topeli A,CAKIR B Evaluation of the blue code system established in the health campus of a university hospital. . 2021; 14 - 19. 10.4103/2452-2473.301912 |
| IEEE | Topeli A,CAKIR B "Evaluation of the blue code system established in the health campus of a university hospital." , ss.14 - 19, 2021. 10.4103/2452-2473.301912 |
| ISNAD | Topeli, Arzu - CAKIR, BANU. "Evaluation of the blue code system established in the health campus of a university hospital". (2021), 14-19. https://doi.org/10.4103/2452-2473.301912 |
| APA | Topeli A, CAKIR B (2021). Evaluation of the blue code system established in the health campus of a university hospital. Turkish journal of emergency medicine (Online), 21(1), 14 - 19. 10.4103/2452-2473.301912 |
| Chicago | Topeli Arzu,CAKIR BANU Evaluation of the blue code system established in the health campus of a university hospital. Turkish journal of emergency medicine (Online) 21, no.1 (2021): 14 - 19. 10.4103/2452-2473.301912 |
| MLA | Topeli Arzu,CAKIR BANU Evaluation of the blue code system established in the health campus of a university hospital. Turkish journal of emergency medicine (Online), vol.21, no.1, 2021, ss.14 - 19. 10.4103/2452-2473.301912 |
| AMA | Topeli A,CAKIR B Evaluation of the blue code system established in the health campus of a university hospital. Turkish journal of emergency medicine (Online). 2021; 21(1): 14 - 19. 10.4103/2452-2473.301912 |
| Vancouver | Topeli A,CAKIR B Evaluation of the blue code system established in the health campus of a university hospital. Turkish journal of emergency medicine (Online). 2021; 21(1): 14 - 19. 10.4103/2452-2473.301912 |
| IEEE | Topeli A,CAKIR B "Evaluation of the blue code system established in the health campus of a university hospital." Turkish journal of emergency medicine (Online), 21, ss.14 - 19, 2021. 10.4103/2452-2473.301912 |
| ISNAD | Topeli, Arzu - CAKIR, BANU. "Evaluation of the blue code system established in the health campus of a university hospital". Turkish journal of emergency medicine (Online) 21/1 (2021), 14-19. https://doi.org/10.4103/2452-2473.301912 |
