Cardiopulmonary resuscitation in a hospitalized population: Prospective study of factors associated with outcome

Suljaga-Pechtel, Kasja; Goldberg, Emanuel; Strickon, Paula; Berger, Marvin; Skovron, Mary Louise

doi:10.1016/0300-9572(84)90061-3

Cited by 80 publications

(41 citation statements)

References 11 publications

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“…In a study of 226 hospitalized CPR recipients, 14% survived to discharge, 10% were alive 6 months later, and COPD was not signifi cantly associated with CPR outcomes. 16 Explanations for why the present fi nding of a strong association between severe COPD and death diff ers from this earlier study include our much larger sample size and that we defi ned severe disease by oxygen dependence or frequent hospitalizations. Several investigations have reported low hospital discharge survival aft er CPR in patients with malignancy.…”

Section: Discussionmentioning

confidence: 59%

“…Most studies either were small or did not capture sufficient data on chronic illness. [14][15][16] Furthermore, long-term survival beyond hospital discharge after CPR remains largely unclear, with studies reporting conflicting results. 6,[16][17][18][19] We, therefore, investigated outcomes after in-hospital CPR in older adults with chronic illness by using 14 years of Medicare hospital data.…”

Section: Discussionmentioning

confidence: 99%

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Long-term Outcomes After In-Hospital CPR in Older Adults With Chronic Illness

Stapleton

Ehlenbach

Deyo

et al. 2014

Chest

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Long-term Outcomes After In-Hospital CPR in Older Adults With Chronic Illness

Stapleton

Ehlenbach

Deyo

et al. 2014

Chest

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“…? Suljaga-Pechtel et al 16 (1984) 207 All adults Y x x x ? Bayer et al 17 (1985) 95 Adults Ն age 65 Y x x Dans et al 18 (1985) 88 All adults Y x x x x Kyff et al 20 (1987) For the studies meeting the minimal inclusion criteria, the overall rate of immediate survival was 43.1% (95% CI 42.5%, 43.6%) and the rate of survival to discharge was 14.6% (95% CI 14.3%, 15.0%).…”

Section: Discussionmentioning

confidence: 99%

Survival after in-hospital cardiopulmonary resuscitation

et al. 1998

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OBJECTIVE:To determine the rates of immediate survival and survival to discharge for adult patients undergoing in-hospital cardiopulmonary resuscitation, and to identify demographic and clinical variables associated with these outcomes. MEASUREMENTS AND MAIN RESULTS:The MEDLARS database of the National Library of Medicine was searched. In addition, the authors' extensive personal files and the bibliography of each identified study were searched for further studies. Two sets of inclusion criteria were used, minimal (any study of adults undergoing in-hospital cardiopulmonary resuscitation) and strict (included only patients from general ward and intensive care units, and adequately defined cardiopulmonary arrest and resuscitation). Each study was independently reviewed and abstracted in a nonblinded fashion by two reviewers. The data abstracted were compared, and any discrepancies were resolved by consensus discussion. For the subset of studies meeting the strict criteria, the overall rate of immediate survival was 40.7% and the rate of survival to discharge was 13.4%. The following variables were associated with failure to survive to discharge: sepsis on the day prior to resuscitation (odds ratio T he do-not-resuscitate (DNR) order has become well accepted and widely used in American hospitals, and for the majority of patients who die in the hospital, a DNR order has been written by the time of their death. 1-3 The decision to discuss or execute a DNR order is driven by several concerns: the patient's current quality of life, the likelihood that cardiopulmonary resuscitation (CPR) will be successful, the patient's long-term prognosis following successful resuscitation, and his or her anticipated quality of life following successful resuscitation. 4,5 Although judgments about quality of life are best assessed by the patient, physicians have typically been relied on to provide biomedical information and estimates of prognosis; this is consistent with a shared approach to medical decision making. Information about prognosis can either be communicated implicitly (e.g., "I don't think CPR is likely to help you") or explicitly ("Patients with your condition have a less than 1% chance of surviving to discharge after CPR"). The explicit approach has been shown in two studies to influence patient decisions about DNR orders, 6,7 so it is important that prognostic information be as accurate as possible.[Recent work has shown, however, that physicians are not accurate in predicting the outcome of CPR. In fact, when presented with detailed vignettes of actual patient cases, physician predictions of the likelihood of immediate survival following CPR were no better than random guessing, with an area under the receiver-operating characteristic (ROC) curve not significantly different from 0.5. 8 An analysis with the physician prediction of the likelihood of survival as the outcome variable in a multivariate regression shows that physicians appear to have an underlying cognitive model. However, this model overemphasizes the imp...

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“…Two retrospective cohort studies also showed no benefit in the use of buffering agents during CPR (LOE 2). 237,238 Two studies demonstrated increased ROSC, hospital admission, and survival at hospital discharge with bicarbonate use (LOE 2 239 ; LOE 3 240 ). Four cohort studies reported that bicarbonate use was associated with poor short-and long-term outcome (LOE 2).…”

Section: Consensus On Sciencementioning

confidence: 99%