A Prospective Study of Survival After In-Hospital Cardiopulmonary Resuscitation and its Related Factors

Abstract

BackgroundDespite several studies, there is no agreement on factors that affect survival after in-hospital cardiopulmonary resuscitation (CPR).ObjectivesThis study aimed to evaluate the survival rate of in-hospital CPR and its related factors at Shahid Beheshti hospital in Kashan, Iran, in 2014.Patients and MethodsA descriptive study was conducted on all cases of CPR performed in Kashan Shahid Beheshti hospital during a 6-month period in 2014. Through a consecutive sampling method, 250 cases of CPR were studied. A three-part researcher-made instrument was used. The outcome of CPR was documented as either survival to hospital discharge or unsuccessful (death of the patient). Chi-square test, t test, and logistic regression analysis were used to analyze the data.ResultsOf all CPR cases, 238 (95.2%) were unsuccessful and 12 (4.8%) survived to hospital discharge. Only 2.6% of patients who were resuscitated in medical units survived to hospital discharge, whereas this rate was 11.4% in the emergency department. Only 45 (18%) patients were defibrillated during resuscitation; in 11 patients, defibrillation was performed between 15 to 45 minutes after the initiation of CPR. The mean time from initiation of CPR to the first DC shock was 13.93 ± 8.88 minutes. Moreover, the mean duration of CPR was 35.11 ± 11.42 minutes. The survival rate was higher in the morning shift and lower during the time of shift change (9.4% vs. 0). The duration of CPR and speed of arrival of the CPR team were identified as factors that predicted the outcome of CPR.ConclusionsThe survival rate after in-hospital CPR was very low. The duration of CPR and the time of initiating CPR effects patients’ outcomes. These findings highlight the crucial role of an organized, skilled, well-established and timely CPR team.

Outcomes of cardiopulmonary resuscitation in the emergency department

“…The survival rate was higher in morning shifts, with no patient surviving CPR in the afternoon shift. This can be owing to higher concentration and stamina of the work force in the morning (17). Likewise, there was a significant difference between the shifts in our study (P < 0.002).…”

The Impact of Senior Early Assessment Model of Care on The Emergency Department’s Improvement Index in a General Teaching Hospital in Southern Iran

“…This rate was 88.6% and 63.36% in studies conducted in Iran (28,29), which indicated a satisfactory condition in the ED. Factors such as CPR duration and time of arrival of the CPR team can predict the CPR outcome (28). In spite of the insufficient trained ED physicians, it has been predicted that the rate of referral to EDs will be 2-fold by 2025 (30).…”

“…The rate of unsuccessful CPR attempts was reported to be higher than 80% in other studies (26,27). This rate was 88.6% and 63.36% in studies conducted in Iran (28,29), which indicated a satisfactory condition in the ED. Factors such as CPR duration and time of arrival of the CPR team can predict the CPR outcome (28).…”

Cardiopulmonary Resuscitation—From the Patient'S Perspective

“…The incidence of in-hospital cardiopulmonary arrest has been reported to be around 1.45 to 3.72 per thousand admissions with only 4.8% to 17% of such patients surviving till hospital discharge [15][16][17][18][19][20] . Other than failing to achieve a return of spontaneous circulation, the associated complications arising from CPR may result in significant morbidity 21 .…”