Wu L, Narasimhan B, Bhatia K, et al. - In in‐hospital cardiac arrest (IHCA), a meaningful neurological recovery is the ideal quality metric but survival is the first step toward this. With increase in overall IHCA rates, improvements in overall survival rates are also evident. However, a plateau in these improvements, especially in the realm of ventricular tachycardia/ventricular fibrillation‐related survival, has been observed in more recent years.

• A 20‐year analysis of a national database [National Inpatient Sample (1999–2018)] was conducted to better characterize evolving patient features and temporal trends in the nature and outcomes of IHCA.

• IHCA rates showed a steady rise, mainly driven by pulseless electrical activity‐asystole arrest, over the 20‐year study span.

• An increase in survival rates by over 10% was noted, post-adjustment for risk factors.

• A similar trend toward improved survival has been observed during recent years (2014–2018), though this only gained statistical significance in the pulseless electrical activity‐asystole cohort.