Arzu Topeli1, Banu Cakir2

1Department of Internal Medicine, Division of Intensive Care Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
2Department of Public Health, Faculty of Medicine, Hacettepe University, Ankara, Turkey

Keywords: Cardiac arrest, cardiopulmonary resuscitation, medical emergency team, mortality, survival


OBJECTIVE: We report the hospital outcomes after implementing the blue code system in our hospital and health campus. We also aimed to determine factors related to mortality.

METHODS: This is a retrospective observational study of the patients who received cardiopulmonary resuscitation (CPR). All blue code calls for all age groups between March 15, 2013, and April 30, 2015 were analyzed. Logistic regression analysis was performed to find independent predictors of in-hospital mortality.

RESULTS: A total of 155 patients from the blue code calls were evaluated. Return of spontaneous circulation was achieved in 45.5% of patients, and 54.8% of the patients had died at the end of the CPR. The hospital discharge rate was 20%. Of all patients, 65% were adults with a survival rate of 7.9%, whereas pediatric patients had a 44.2% survival rate. Asystole and pulseless electrical activity were the predominant electrocardiography rhythms in 92.4% of patients. The comparison of survivors and nonsurvivors revealed that nonsurvivors were older, had more cancer as the comorbidity, had a more cardiac arrest, and sepsis as the underlying cause and had >20 min of CPR. The logistic regression analysis demonstrated the independent risk factors for mortality as arrest at a hospital ward, and sepsis as the underlying cause and being adult patient.

CONCLUSION: The performance of the blue code system should be evaluated periodically. Every effort should be made to prevent unexpected cardiac arrests and increase hospital discharge with good neurologic outcomes.

How to cite this article: Topeli A, Cakir B. Evaluation of the blue code system established in the health campus of a university hospital. Turk J Emerg Med 2021;21:14-9

Ethics Committee Approval

Hacettepe University Ethical Committee approval was obtained on 29.4.2015 (GO 15/300-04).

Author Contributions

AT conceived, designed the project and gathered the data and wrote the manuscript; AT, BC analyzed and interpreted the data.

Conflict of Interest

None declared.

Financial Disclosure

None declared.


This manuscript is the publication of the Epidemiology Master of Science Dissertation Thesis of Prof.Dr. Arzu Topeli and her instructor Prof.Dr. Banu Cakir in Hacettepe University Medical Sciences Institute, completed in 2016. The authors are grateful to all physicians, nurses, and other health care personnel who took part in the establishment and advancing the blue code system and gathering the data.