Outcome of cardiopulmonary resuscitation in hospitalized patients

Background: Information on who is likely to benefit from cardiopulmonary resuscitation (CPR) is essential for decision-making regarding resuscitative efforts. The purpose of the present study was to evaluate the results of CPR in hospitalized patients and to investigate the influence of clinical variables and their value as prognostic tools. Methods: We analysed prospectively collected data of 253 consecutive hospitalized patients in whom CPR was performed. Main outcome measures were: success of CPR, 24-h survival, discharge from hospital, mental status at the time of hospital discharge, diagnosis, age, adequacy of basic life support, duration of CPR, time of CPR. Results: The mean age was 69.5 years, with a range of 27 to 97 years. Distribution of sex was 145 men and 108 women. Of 253 CPR efforts, 141 (56%) were successful, and in 110 (43%), patients were alive after 24 h. Fifty patients (20%) were discharged alive. The mechanism of arrest with the best outcome was ventricular tachycardia or fibrillation. Advanced age and adequacy of basic life support by first-responders did not affect survival to discharge. Prolonged duration of the resuscitative effort was associated with a poor outcome. Among patients whose arrest lasted longer than 30 min, 89% died. Conclusion: 20% of patients who underwent in-hospital resuscitation were discharged alive. Need for prolonged resuscitation as well as certain mechanisms of arrest, such as progression of a shock state, were associated with a poor outcome. Patients who are likely to benefit from CPR performed for >30 min are rare. Therefore, a decision for prolonged CPR should be made only in reasonable cases.