Interventions to reduce mortality from in-hospital cardiac arrest

Data from the National Cardiac Arrest Audit were used in a mixed-methods research study to explore changes over time associated with the introduction of interventions aimed at identification and management of deteriorating patients.

About the study

Researchers from the London School of Hygiene and Medicine, in collaboration with ICNARC, undertook a mixed-methods research study, which involved interviewing staff alongside a survey of NHS hospitals and analyses of existing data. The research was funded by the National Institute for Health and Care Research Health Services and Delivery Research programme.

The research found that over a six-year period from 2009/10 to 2014/15, the rates of in-hospital cardiac arrests attended by a resuscitation team fell by 6% per year and survival increased by 5% per year. Improvements in outcomes were particularly associated with the introduction of a standardised ‘track & trigger’ warning system—the National Early Warning Score (NEWS)—to monitor patients’ vital signs and alert staff to potential deterioration, and with the transition from paper-based to electronic track & trigger systems.

How were ICNARC data used

Data from the National Cardiac Arrest Audit on patients who had an in-hospital cardiac arrest formed the basis of the analyses of existing data. These data were linked with Hospital Episode Statistics data from NHS England to provide additional information on the hospital admission, with civil registrations so that deaths within 30 or 90 days of a cardiac arrest could be reported, and with a survey of hospitals so that changes in the hospitals’ approaches to identifying and caring for deteriorating patients could be identified and compared.