Pre-resuscitation factors associated with mortality in 49,130 cases of in-hospital cardiac arrest: A report from the National Registry for Cardiopulmonary Resuscitation (original) (raw)
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Outcomes of Cardiopulmonary Resuscitation and Its Predictors in Hospitalized Patients
Multidisciplinary Cardiovascular Annals
Background: Cardiopulmonary resuscitation (CPR) has been a frequently performed medical intervention that increases the chance of survival of a person stricken by cardiac arrest, and there is an excellent value of diversity in the rate of successful rehabilitation in societies. Methods: A retrospective observational study was carried out. The medical records of all in-hospital and out-hospital cardiac arrest patients who underwent CPR were collected. A total of 587 people with who underwent CPR during two years between January 2017 and June 2018, using a designed form were enrolled. Demographic information, the ward which CPR was committed, hospitalization, the delay before the onset of CPR and time of the day were recorded. Results: The overall success rate of CPR in this study was 25.89%. There was no significant difference in the success rate of CPR between men and women. A comparison of age groups revealed a difference between the success rates of CPR in 14 - 64 years group comp...
2011
Purpose. Our objective was to perform a systematic review of pre-arrest predictors of the outcome of in-hospital cardiopulmonary resuscitation (CPR) in adults. Methods. We searched PubMed for studies published since 1985 and bibliographies of previous meta-analyses. We included studies with predominantly adult patients, limited to in-hospital arrest, using an explicit definition of cardiopulmonary arrest and CPR and reporting survival to discharge by at least one pre-arrest variable.
A decade of in-hospital resuscitation: Outcomes and prediction of survival?
Resuscitation, 2006
Objective: To provide survival rates and associated factors from a 10-year study of in-hospital cardiopulmonary resuscitation (CPR). Design: Longitudinal prospective case register study of all adult in-hospital CPR attempts conducted from April 1993 to March 2003. Setting: 1200-bed general hospital in Plymouth (UK). Patients: 2121 adult in-hospital CPR attempts in Derriford Hospital, Plymouth during the period April 1993-March 2003. Main outcome measures: Immediate, 24 h, hospital discharge and 12 month survival rates.
Journal of Academic Research in Medicine, 2020
Objective: In this study, we aimed to investigate demographic data of patients who were arrested in an emergency department and outside the hospital, who died despite effective cardiopulmonary resuscitation (CPR), how they were admitted to the emergency department, blood parameters, additional diseases, and duration of CPR. Methods: Two hundred two patients whose complete records can be accessed were included in the study. Demographic data of patients, emergency department arrival patterns, vital signs, additional diseases, blood gas pH, lactate, base minus values, CPR duration and adrenaline doses used in CPR were recorded. Results: Two hundred twenty-one (59.90%) of the patients were male and 81 (40.09%) were female. Of the men, 69 (57.02%) were in the emergency department and 52 (42.97%) were outside the hospital. Fifty (61.72%) of the women were arrested in the emergency department and 31 (32.27%) were arrested outside the hospital. The average age of men was 70 and the average age of women was 80. In the group with non-hospital arrest, there was a significant difference between base minus, lactate and pH values in arterial blood gas compared to the group with in-hospital arrest. Conclusion: Cardiopulmonary arrest is a very important health problem that is common in emergency departments and has a high rate of mortality. The society should be made aware of early diagnosis, timely and correct intervention, and rapid transfer of arrested cases outside the hospital. Advanced age, concomitant comorbid diseases, and prolonged CPR times are directly associated with mortality.
In-Hospital Resuscitation: Executive Summary
Annals of Emergency Medicine, 1997
The Emergency Cardiac Care (ECC) Committee of the American Heart Association (AHA) first published guidelines for CPR and ECC in 1974.1 Updated in 1980, 1986, and 1992, the AHA guidelines are now recognized as the world's most authoritative resuscitation guidelines. 2-4 To implement these guidelines, however, hospitals need to establish a systems approach to in-hospital resuscitation rather than depend on the skills of individual professionals. The success and acceptance of the out-of-hospital Utstein style recommendations 5 led the AHA to help develop specific recommendations for documenting in-hospital resuscitation. The Utstein style recommendations for uniform reporting of in-hospital resuscitations present important recommendations for atl hospital facilities. 6 With the publication of these recommendations, members of the ECC Committee recognized the need to summarize the major actions that enable a hospital to fulfill the resuscitation recommendations. ETHICAL CONCERNS CPR is one of the few interventions that requires an order to not be administered. Resuscitation efforts, however, are not appropriate for all hospital patients. When indicated, health care providers discuss with patients, families, and surrogate decisionmakers their options and preferences for resuscitation. Hospitals have in place clear policies that address medical futility, patient self-determination, and do-notattempt-resuscitation orders. IN-HOSPITAL "CHAIN OF SURVIVAL" The chain of survival, first conceptualized for out-of-hospital sudden cardiac arrest, r applies to in-hospital arrest as well. s Successful resuscitation requires early recognition of cardiopulmonary arrest, early activation of trained responders,
Factors affecting outcome following cardiopulmonary resuscitation
Anaesthesia and intensive care, 1994
Many patients who receive cardiopulmonary resuscitation (CPR) for cardiac arrest do not survive to leave hospital. Factors associated with adverse outcomes include unwitnessed cardiac arrest in general wards, particularly at night, prolonged resuscitation, asystole, associated disorders (e.g. sepsis, malignancy, renal failure, and left ventricular dysfunction), absent pupillary responses, hypoxaemia, low PetCO2 during resuscitation, and severe acid base imbalance. Outside hospitals, cardiac arrests result in more favourable outcomes if they occur at work, and bystander CPR and early defibrillation are initiated. On admission to ICU, likely predictors of death or severe neurological disability include prolonged coma, impaired brainstem reflexes, and persistent convulsions. Experience with cerebrospinal fluid enzymes and electrophysiological measurements is limited. Multivariate scoring systems are not sufficiently reliable. The importance of hyperglycaemia, the required level of CPR ...
Risk Factors in Reducing Mortality from in-hospital Cardiopulmonary Resuscitation
Saudi Journal of Oral and Dental Research
Introduction: In-hospital cardiac arrest is a common health problem associated with high levels of mortality, our goal is to identify the important elements that play a significant role in lowering cardiopulmonary resuscitation (CPR) in-hospital (code Blue) death rates. Methods: this was a retrospective cohort study, involving patients who had in-hospital CPR at Heraa General Hospital from January 2020 to June 2022. The data was collected from the hospital's information center. Results: our sample population was over 600 patients, selected randomly from the hospital's information center. Consist of 55.1% males and 44.5% of them were females with 53.9% having Pulseless Electrical Activity (PEA) as initial cardiac rhythm. The following variables: age, intubated before CPR, intubated during CPR, initial cardiac rhythm, Adrenaline 1mg, and Amiodarone 300mg showed P-valve less than 0.05. Conclusion: There is statistically significant association between the clinical variables: In...
Factors Associated with Survival Rate after Cardiopulmonary Resuscitation
Journal of Holistic Nursing and Midwifery, 2017
Introduction: Cardiovascular disease is considered as the most important cause of mortality among men and women throughout the world. This condition causes sudden cardiac arrest in more than half of the cases. To reduce mortality due to this disease, cardiopulmonary resuscitation (CPR) and the determinants of its success are the focus of researchers. Objective: The aim of this study was to determine the survival rate of CPR and its associated factors in patients with in-hospital cardiac arrest in a teaching medical center in Rasht. Materials and Methods: The present descriptive-analytic cross-sectional study investigated 100 patients undergoing CPR during spring-summer 2014 at Specialized Cardiology Center in Rasht. The instrument of this study was the standard checklist of Utstein-Style that included information on age, gender, cause of cardiac arrest, rhythm, work shift, CPR place, interval of cardiac arrest until arrival of CPR team, interval of cardiac arrest until shock, interval of cardiac arrest until intubation, interval of cardiac arrest until CPR termination, short-term and long-term outcomes of CPR, and brain function status until discharge from the hospital. Data was analyzed using descriptive statistics (mean, standard deviation) and analytic analyses (T-test, Fisher's exact test, analysis of variance, and logistic regression). Results: A total of 53% of subjects were male and mean age of the patients was 68.6 ± 14.4 years; 30% of patients who underwent CPR had short-term survival, and 11% were discharged with appropriate brain status with Glasgow Coma Scale (GCS=15). Multiple logistic regression (Backward LR method) revealed that only gender (p=0.008, OR=6.46, CI95%: 1.63-25.5) and electric shock (p=0.03, OR=4.1, CI95%: 1.1-15.14) were statistically significant predictors of short-term survival. Conclusion: According to the results of this study, time is an important factor in CPR outcome and increasing the survival rate and timely use of electric shock can be an effective measure in shockable rhythms. Appropriate planning, training staff, and using appropriate facilities, as well as establishment of a primary warning system for calling CPR team in health centers can increase the success rate of CPR.