{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:01:41Z","timestamp":1785391301749,"version":"3.55.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Objective<\/jats:title>\n To analyze hospital code blue team (HCBT) call data over a 10-year period and to explore call characteristics and factors associated with clinical outcomes following in-hospital cardiac arrest (IHCA).<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A single-center retrospective cohort study conducted over 10\u202fyears.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n A tertiary hospital in China providing comprehensive inpatient care.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n A total of 454 patients who experienced IHCA and triggered HCBT activation between January 2016 and December 2025 were included. The mean age was 65.76\u202fyears (SD 14.71), and 55.95% were male.<\/jats:p>\n <\/jats:sec>\n \n Data analysis<\/jats:title>\n \n Descriptive statistics were used to summarize baseline characteristics and call features. Independent-samples\n t<\/jats:italic>\n tests and\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n tests were applied for group comparisons. Multivariable logistic regression analysis was performed to identify independent associated factor of unfavourable outcome.\n <\/jats:p>\n <\/jats:sec>\n \n Primary outcome measures<\/jats:title>\n The primary outcome was clinical outcome following HCBT activation. Outcomes were classified as favourable (remained on the ward, survival requiring transfer to the intensive care unit, emergency department, or operating room for continued treatment) or unfavourable (in-hospital death or discharge against medical advice). All data were obtained from the institutional HCBT database.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 454 HCBT activations were recorded during the study period. The most common underlying diagnoses were circulatory, respiratory, and digestive system diseases. Following resuscitation, the majority of patients were transferred to the intensive care unit (ICU) (50.22%), while a smaller proportion remained in the ward (10.13%). The proportion of discharge against medical advice was 27.53%, and the direct in-hospital mortality rate was 8.59%. The five-minute arrival rate of the HCBT was 98.68%. Advanced age was independently associated with unfavourable clinical outcome. Events occurring during daytime hours were associated with improved survival. In addition, cases first recognized by healthcare professionals demonstrated significantly better outcomes compared with those identified by caregivers.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n IHCA most frequently occurred in patients with cardiovascular and respiratory diseases. Although the team achieved a high five-minute arrival rate, overall survival remained suboptimal, particularly among older patients. Daytime events and early recognition by healthcare professionals were associated with better survival outcomes, highlighting the importance of rapid response and system-level improvements to improve in-hospital resuscitation performance.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1853771","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:40:00Z","timestamp":1785390000000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Call characteristics and factors associated with outcomes of in-hospital cardiac arrest response teams: a 10-year retrospective cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Guoping","family":"Yuan","sequence":"first","affiliation":[{"name":"Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijie","family":"Wang","sequence":"additional","affiliation":[{"name":"Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Jiang","sequence":"additional","affiliation":[{"name":"Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Sun","sequence":"additional","affiliation":[{"name":"Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiafen","family":"Li","sequence":"additional","affiliation":[{"name":"Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Gong","sequence":"additional","affiliation":[{"name":"Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongying","family":"Pan","sequence":"additional","affiliation":[{"name":"Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1007\/s00392-022-02084-1","article-title":"Clinical characteristics, causes and predictors of outcomes in patients with in-hospital cardiac arrest: results from the SURVIVE-ARREST study","volume":"112","author":"Hannen","year":"2023","journal-title":"Clin Res Cardiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1186\/s13054-018-2060-7","article-title":"Prognostication after cardiac arrest","volume":"22","author":"Sandroni","year":"2018","journal-title":"Crit Care"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1001\/JAMA.2019.1696","article-title":"In-hospital cardiac arrest: a review","volume":"321","author":"Andersen","year":"2019","journal-title":"JAMA"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e31796","DOI":"10.5812\/traumamon.31796","article-title":"A prospective study of survival after in-hospital cardiopulmonary resuscitation and its related factors","volume":"21","author":"Miranzadeh","year":"2016","journal-title":"Trauma Mon"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.jcrc.2017.05.006","article-title":"The impact of delayed rapid response call activation on patient outcomes","volume":"41","author":"Gupta","year":"2017","journal-title":"J Crit Care"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"831","DOI":"10.21037\/jtd-20-1573","article-title":"Application of extracorporeal cardiopulmonary resuscitation in adult patients with refractory cardiac arrest","volume":"13","author":"Guo","year":"2021","journal-title":"J Thorac Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e003638","DOI":"10.1161\/JAHA.116.003638","article-title":"Location of in-hospital cardiac arrest in the United States-variability in event rate and outcomes","volume":"5","author":"Perman","year":"2016","journal-title":"J Am Heart Assoc"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"987","DOI":"10.3390\/jcm15030987","article-title":"Disparities in survival after in-hospital cardiac arrest by time of day and day of week: a single-center cohort study","volume":"15","author":"Aggou","year":"2026","journal-title":"J Clin Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1007\/s00101-025-01592-9","article-title":"Arrival times of emergency services in out-of-hospital cardiac arrest-survival-relevant differences between federal states in Germany","volume":"74","author":"Fischer","year":"2025","journal-title":"Anaesthesiologie"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"43","DOI":"10.4103\/aca.aca_102_25","article-title":"Impact of introduction of code blue response system in a cardiorespiratory center: before-after study","volume":"29","author":"Kumar","year":"2026","journal-title":"Ann Card Anaesth"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1186\/s13054-015-0973-y","article-title":"Rapid response systems: a systematic review and meta-analysis","volume":"19","author":"Maharaj","year":"2015","journal-title":"Crit 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A prospective clinical observational study (WHY-IHCA)","volume":"216","author":"Lind","year":"2025","journal-title":"Resuscitation"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e107692","DOI":"10.1136\/bmjopen-2025-107692","article-title":"Temporal trends in the causes of in-hospital cardiac arrest: a retrospective observational cohort study on the limitations of the current alert system at a tertiary hospital in Korea","volume":"15","author":"Lee","year":"2025","journal-title":"BMJ Open"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.resuscitation.2022.03.005","article-title":"Etiologies of in-hospital cardiac arrest: a systematic review and meta-analysis","volume":"175","author":"Allencherril","year":"2022","journal-title":"Resuscitation"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1016\/j.ajem.2018.10.003","article-title":"Characteristics and outcomes of in-hospital cardiac arrest in adults hospitalized with acute coronary syndrome in China","volume":"37","author":"Li","year":"2019","journal-title":"Am J Emerg Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"28","DOI":"10.18087\/cardio.2025.5.n2719","article-title":"Clinical characteristics and factors influencing the outcomes of in-hospital cardiac arrest patients: a retrospective observational study","volume":"65","author":"Xu","year":"2025","journal-title":"Kardiologiia"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.resuscitation.2017.07.013","article-title":"Survival and neurological outcome in the elderly after in-hospital cardiac arrest","volume":"118","author":"Hirlekar","year":"2017","journal-title":"Resuscitation"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1136\/bmjqs-2019-009487","article-title":"Nursing roles for in-hospital cardiac arrest response: higher versus lower performing hospitals","volume":"28","author":"Guetterman","year":"2019","journal-title":"BMJ Qual Saf"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1097\/MLR.0000000000000456","article-title":"Better nurse staffing and nurse work environments associated with increased survival of in-hospital cardiac arrest patients","volume":"54","author":"McHugh","year":"2016","journal-title":"Med Care"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2016\/4626027","article-title":"The prognosis of cardiac origin and noncardiac origin in-hospital cardiac arrest occurring during night shifts","volume":"2016","author":"Syue","year":"2016","journal-title":"Biomed Res Int"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1016\/j.jacc.2017.11.043","article-title":"Trends in survival after in-hospital cardiac arrest during nights and weekends","volume":"71","author":"Ofoma","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.3760\/cma.j.issn.2095-4352.2016.12.002","article-title":"Chinese expert consensus on cardiopulmonary resuscitation 2016","volume":"12","author":"Wang","year":"2016","journal-title":"Chin Crit Care Med"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1853771\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:40:03Z","timestamp":1785390003000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1853771\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,30]]},"references-count":23,"alternative-id":["10.3389\/fpubh.2026.1853771"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1853771","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,30]]},"article-number":"1853771"}}