Background: Cardiopulmonary resuscitation (CPR) is a critical life-saving intervention performed across various hospital settings. The outcomes of in-hospital cardiac arrest (IHCA) are influenced by factors such as the location of arrest, timeliness of intervention, initial cardiac rhythm, and resuscitation quality. However, limited data exists comparing CPR outcomes specifically between arrests occurring within the Emergency Department (ED) and other hospital departments in the Indian context. Objectives: To compare CPR outcomes—Return of Spontaneous Circulation (ROSC), survival to admission (STA), and survival to discharge (STD)—between cardiac arrests occurring in the ED and those outside the ED. Secondary objectives included identifying factors associated with ROSC and STD. Methods: This was a retrospective observational study conducted in a tertiary care hospital over a 13-month period. Data were collected from records of adult patients (>18 years) who underwent CPR. Patients were grouped based on arrest location: ED vs. out-of-ED (ICUs, wards, cath lab). Variables analysed included demographics, arrest characteristics, resuscitation parameters, and outcomes. Statistical analysis was performed using chi-square tests and logistic regression. Results: Among 170 patients, ROSC was achieved in 40.7% of ED arrests compared to 26.9% out-of-ED (p = 0.045). STA and STD were higher in ED arrests, though not statistically significant. Predictors of ROSC included witnessed arrest, initial shockable rhythm, and CPR duration ≤20 minutes. Conclusion: Arrests occurring in the ED are associated with significantly better immediate CPR outcomes. Enhanced monitoring and rapid response capabilities in the ED contribute to this benefit, highlighting the need to strengthen resuscitation readiness hospital-wide.

Cardiopulmonary resuscitation, emergency department, in-hospital cardiac arrest, ROSC, survival outcomes, arrest location, resuscitation.