Design: Multicentre prospective registry
Population: 17,602 adults with in-hospital cardiac arrest at 37 hospitals in China
Primary outcome: Survival to 30 days or hospital discharge
Effect: 9.1% survived; 7.1% with favourable neurological outcome; 6.1% alive at 12 months

A registry across 37 hospitals in 29 Chinese provinces captured 17,602 adults who had in-hospital cardiac arrest and received CPR during 2019 and 2020. Incidence was 4.1 per 1000 admissions; 13.5% had a shockable first rhythm.

CPR started within a minute in 95.9%, and timely defibrillation or adrenaline was achieved in most. Yet only 35.2% had sustained return of circulation, and of those, 3.6% received temperature control and 5.2% coronary angiography. Survival to 30 days or discharge was 9.1%, with 7.1% neurologically intact; at 12 months 6.1% were alive.

The authors point to post-arrest care and to rare use of do-not-attempt-resuscitation orders, which means many arrests are expected deaths in very sick patients. Both points apply in Indian hospitals, where comparable multicentre data are scarce.

Survival after return of circulation depends on post-arrest care: check for a coronary cause and manage temperature and oxygenation
Consider urgent angiography after arrest when a cardiac cause is suspected
Discuss resuscitation preferences early with seriously ill patients and families
Audit your own hospital's arrest outcomes; speed of CPR alone does not guarantee survival

Why it matters

It shows that in middle-income hospitals the weak link may come after the heart restarts, not before.

The statistics, in plain English

This is a descriptive registry, so it shows what happened, not what would work. The low rates of temperature control and angiography are associations with poor outcomes, not proof that adding them would raise survival by a set amount.