In-hospital cardiopulmonary resuscitation: patient, arrest and resuscitation factors associated with survival

Resuscitation. 1990 Oct;20(2):115-28. doi: 10.1016/0300-9572(90)90047-i.

Abstract

Data on 470 adults with single in-hospital cardiac arrest resuscitations were analyzed to determine 24-h and discharge survival rates and to identify significant correlates of survival. One hundred fifty-three (33%) patients were alive 24 h after initiation of cardiopulmonary resuscitation; 69 (45% of 24-h survivors, 15% of all patients) were discharged alive. Logit analysis identified the following independently significant correlates of 24-h survival: arrest locations other than emergency room or cardiac care unit, CPR duration less than 15 min, non-cardiac primary diagnosis, non-asystolic dysrhythmia, less than one intravenous and one drip-administered inotrope and absence of pacemaker insertion and defibrillation. Fifty-one (94%) of 54 patients with all of these characteristics were alive 24 h after initiation of CPR. The same variables, as well as age less than 68 years and absence of intubation were statistically associated with discharge survival. Nine (64%) of 14 patients with all of these characteristics were discharged alive. Increased intervention was generally associated with increased mortality. Overall survival rates replicate previous reports and may reflect the effects of diagnosis-related groups policies on the average illness severity of the in-patient population, rather than failure of current CPR methods to improve the probability of survival. Use of the data as baseline for future studies and as a source of hypotheses for research on decision making are discussed.

MeSH terms

  • Aged
  • Critical Care / organization & administration
  • Female
  • Heart Arrest / mortality*
  • Hospitals*
  • Humans
  • Male
  • Middle Aged
  • New York
  • Resuscitation / methods*
  • Survival Analysis
  • Survival Rate