In-hospital medication administration prior to in-hospital cardiac arrest: a matched case-control study

Background Limited research has examined medication administration in patients with in-hospital cardiac arrest (IHCA). We aimed to identify and describe in-hospital medications administered 24 h prior to IHCA compared with matched controls. Methods This study was a registry-based, matched, case-control study including patients who were hospitalized in the Central Denmark Region from 2017 to 2022. Patients with IHCA were matched with hospitalized controls on age, sex, length, and period of admission. The index time was defined as the time of IHCA for cases, and a corresponding index time was assigned to matched controls. Medication administrations within 24 h prior to index time were identified and divided into 21 groups based on ATC codes, e.g. QTc-prolonging drugs. New medication administrations were defined as no prior redeemed prescription for the same ATC code within 2 years. Results A total of 1,976 cases and 19,716 controls met the study criteria and were included in the study. Among cases, the most frequently administered medication groups were antithrombotic agents (43% of cases), antibiotics (42%), and diuretics (35%), whereas for controls the groups were antibiotics (33% of controls), antithrombotic agents (33%), and opioids (24%). Overall, cases were administered a median of 11 (IQR: 0–20) medications within 24 h prior to the index time as compared to 5 (IQR: 0–14) medications for controls. Conclusion Medications administered in-hospital within 24 h prior to IHCA differed from those in matched controls and were characterized by a higher proportion of newly initiated treatments. These findings may help form new hypotheses on strategies on prevention of IHCA.