Impact of nurse empowerment for early adrenaline administration for in-hospital cardiac arrest resuscitation: A pre-post intervention study

Table 6 Comparison of outcomes between pre-intervention and post-intervention periods for all patients and excluding in-hospital cardiac arrest during coronavirus disease era¹

Discrete variables	All patients		Excluding COVID era
	OR/median difference (95%CI)	P value	OR/median difference (95%CI)	P value
Timely adrenaline2	3.39 (2.18-5.29)	< 0.001	3.47 (2.10-5.74)	< 0.001
Number obtained ROSC	1.10 (0.74-1.67)	0.61	1.19 (0.75-1.89)	0.43
Number shifted to ICU	0.84 (0.56-1.27)	0.39	0.82 (0.52-1.29)	0.37
Survival at 24-hour	0.74 (0.48-1.14)	0.15	0.84 (0.52-1.36)	0.46
Mortality	1.79 (0.97-3.26)	0.04	1.61 (0.82-3.21)	0.14
Time to 1st adrenaline, minutes	2 (1-2)	< 0.001	2 (1-2)	< 0.001
No. of doses of adrenaline	-1 (-1 to 0)	0.007	-1 (-1 to 0)	0.01
No. of cycles of CPR	0 (-2 to 1)	0.62	0 (-1 to 1)	0.80

¹For all patients, mortality was higher in the post-intervention period when compared with the post-intervention period. There was no difference in the number of patients who achieved return of spontaneous circulation in the two periods. However, timely administration of adrenaline was significantly more likely in the post-intervention period when compared with the pre-intervention period. The number who were shifted to intensive care unit and were alive at 24-hour were not significantly different. Sensitivity analysis with the exclusion of in-hospital cardiac arrest during the coronavirus disease era (defined as the period from June 1, 2020 till August 31, 2021) showed that the results were unchanged except for mortality, which became insignificant with the exclusion of the coronavirus disease era in-hospital cardiac arrests.

²Indicates administration of the 1^st dose of adrenaline within 2 minutes.

CPR: Cardiopulmonary resuscitation; ROSC: Return of spontaneous circulation; IHCA: In-hospital cardiac arres; OR: Odds ratio; CI: Confidence interval; ICU: Intensive care unit; COVID: Coronavirus disease.