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Background <p>Acute poisoning is a recognized special circumstance in cardiac arrest, yet data on acute poisoning-related in-hospital cardiac arrest (IHCA) remain limited. This study aimed to describe the toxicant spectrum, presentation-to-IHCA interval, pre-arrest physiological status, resuscitation characteristics, and hospital outcomes among patients with acute poisoning-related IHCA.</p> Methods <p>We performed a single-center retrospective descriptive study of consecutive emergency department presentations for acute poisoning between January 1, 2023 and January 1, 2026. Eligible presentations included patients who developed IHCA after hospital arrival and were treated with chest compressions, defibrillation, or both. We extracted toxicant categories, presentation-to-IHCA interval, the most recent documented pre-arrest assessment within 1&#xa0;h before IHCA, resuscitation characteristics, and in-hospital outcomes.</p> Results <p>Among 2,016 consecutive presentations for acute poisoning, 16 index IHCA events occurred in 16 patients (0.79%). Pesticide exposure was identified in 12 cases, including bipyridyl herbicides in 6, organophosphate pesticides in 3, and other pesticides in 3. Non-pesticide toxicants included aconitine in 2 patients, a cardiac glycoside-containing plant in 1, and mixed antipsychotic drugs in 1. Twelve of 16 IHCA events occurred within 24&#xa0;h of presentation. The median interval between the last documented pre-arrest assessment and IHCA onset was 11.0&#xa0;min (IQR, 7.3–30.8; range, 2–53). Documented pre-arrest assessments showed abnormalities in consciousness and hemodynamic status. The median Glasgow Coma Scale score was 8 (IQR, 3–13.5), 9 patients had a score ≤ 8, and 6 required vasoactive support before arrest, of whom 4 remained hypotensive at the most recent assessment. Initial arrest rhythm was shockable in 2 patients, non-shockable in 9, and unknown in 5. Return of spontaneous circulation (ROSC) was achieved in 13 patients; 3 patients survived to discharge, and all survivors had favorable neurological status at discharge.</p> Conclusions <p>Acute poisoning-related IHCA was uncommon but associated with substantial mortality in this single-center descriptive cohort. Pesticide exposure predominated, most IHCA events occurred within 24&#xa0;h of presentation, documented pre-arrest abnormalities were observed, and hospital survival remained poor despite frequent ROSC. These findings provide descriptive in-hospital data on a rare toxicological cardiac arrest subgroup and should not be interpreted as identifying predictors of IHCA.</p>

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Clinical characteristics of acute poisoning-related in-hospital cardiac arrest: a single-center retrospective study

  • 期刊论文

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  • 发表日期：

    2026年7月30日

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  • Shuhao Ye,
  • Jiujiu Gui,
  • Pinxuan Zhou,
  • Nanwei Lin,
  • Zhongqiu Lu

摘要

Background

Acute poisoning is a recognized special circumstance in cardiac arrest, yet data on acute poisoning-related in-hospital cardiac arrest (IHCA) remain limited. This study aimed to describe the toxicant spectrum, presentation-to-IHCA interval, pre-arrest physiological status, resuscitation characteristics, and hospital outcomes among patients with acute poisoning-related IHCA.

Methods

We performed a single-center retrospective descriptive study of consecutive emergency department presentations for acute poisoning between January 1, 2023 and January 1, 2026. Eligible presentations included patients who developed IHCA after hospital arrival and were treated with chest compressions, defibrillation, or both. We extracted toxicant categories, presentation-to-IHCA interval, the most recent documented pre-arrest assessment within 1 h before IHCA, resuscitation characteristics, and in-hospital outcomes.

Results

Among 2,016 consecutive presentations for acute poisoning, 16 index IHCA events occurred in 16 patients (0.79%). Pesticide exposure was identified in 12 cases, including bipyridyl herbicides in 6, organophosphate pesticides in 3, and other pesticides in 3. Non-pesticide toxicants included aconitine in 2 patients, a cardiac glycoside-containing plant in 1, and mixed antipsychotic drugs in 1. Twelve of 16 IHCA events occurred within 24 h of presentation. The median interval between the last documented pre-arrest assessment and IHCA onset was 11.0 min (IQR, 7.3–30.8; range, 2–53). Documented pre-arrest assessments showed abnormalities in consciousness and hemodynamic status. The median Glasgow Coma Scale score was 8 (IQR, 3–13.5), 9 patients had a score ≤ 8, and 6 required vasoactive support before arrest, of whom 4 remained hypotensive at the most recent assessment. Initial arrest rhythm was shockable in 2 patients, non-shockable in 9, and unknown in 5. Return of spontaneous circulation (ROSC) was achieved in 13 patients; 3 patients survived to discharge, and all survivors had favorable neurological status at discharge.

Conclusions

Acute poisoning-related IHCA was uncommon but associated with substantial mortality in this single-center descriptive cohort. Pesticide exposure predominated, most IHCA events occurred within 24 h of presentation, documented pre-arrest abnormalities were observed, and hospital survival remained poor despite frequent ROSC. These findings provide descriptive in-hospital data on a rare toxicological cardiac arrest subgroup and should not be interpreted as identifying predictors of IHCA.