CPR Outcomes in Hospitalized Patients with Tracheostomies

Abstract

Objective: 1) Outcomes of cardiac arrest in hospitalized patients with tracheostomies. 2) Disposition of patients at the time of hospital discharge. Method: A retrospective electronic chart review was performed of 1102 patients who had cardiac arrest (absence of pulse or non-perfusing rhythm) at a tertiary care academic medical center between Jan 2005-Dec 2009. Data was abstracted and summarized using descriptive statistics. Results: Twenty-six of 1102 (2%) had a tracheostomy at the time of arrest. Median age years = 61 years (range 24-83 years). A total of 18 out of 26 (69%) were male. A total of 18 out of 26 (69%) had return of spontaneous circulation following resuscitation. Fourteen out of 26 (54%) were on mechanical ventilation (MV) at the time of arrest. Twenty-two out of 26 (84%) patients had tracheostomy secondary to prolonged MV. Twelve out of 26 (46%) patients were alive at 3 months and 7 out of 26 (26%) patients were alive at 1 year. Of the 11 patients who survived to discharge, disposition included: 6 out of 11 (54%) home; 3 out of 11 (27%) long-term acute care hospital (LTAC); 2 out of 11 (18%) skilled nursing facility (SNF). Conclusion: The frequency of cardiac arrest in patients with a tracheostomy was 2.4%. Survival at 1 year was 26%. Of those who survived to discharge, 54% of patients went home and 45% were discharged to a LTAC or SNF.