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

Stapleton, Renee D.; Ehlenbach, William J.; Deyo, Richard A.; Curtis, J. Randall

doi:10.1378/chest.13-2110

Cited by 29 publications

(30 citation statements)

References 32 publications

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“…In this study, 55% of patients were male. Stapleton et al conducted a study to compare the result of CPR in patients with or without chronic diseases and found that patients suffering from chronic illnesses had a smaller chance of surviving cardiopulmonary arrest (P <0.001) (14). This was also the case in our study, but exact information is needed to make comparisons.…”

Section: Discussionsupporting

confidence: 63%

Outcomes of cardiopulmonary resuscitation in the emergency department

Haghighi

Vahdati

Mahmoudie

et al. 2017

J Emerg Pract Trauma

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Objective: Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in the prevention of death or delaying it in a person with cardiac arrest. In this regard, demographic information about patients who need CPR is vital. Methods: In this cross-sectional study patients with cardiopulmonary arrest or arrhythmias admitted to Imam Reza and Sina educational hospitals of Tabriz University of Medical Sciences from 22 December 2013 to 21 December 2014 entered the study. Demographic information such as age, sex, cardiopulmonary resuscitation time, the place of cardiopulmonary arrest (outside or inside the hospital), the duration of resuscitation process, success or failure of the resuscitation process and the mechanism of cardiopulmonary arrest were obtained. Results: From a total of 354 cases of cardiopulmonary resuscitation, 281 cases (79%) were unsuccessful and 73 cases (21%) were successful. The average age of patients was 59 ± 22 years. The average time of the resuscitation process was 31 ± 12 minutes. There was a significant difference between the mean of age and resuscitation time in patients who had experienced successful or unsuccessful resuscitation (P = 0.0001). There was a significant relationship between sex and the success rate of resuscitation (P = 0.0001). In addition, a significant relationship between the success of the resuscitation operation and the ward of resuscitation was observed (P = 0.0001). Conclusion:The most common mechanism leading to cardiopulmonary arrest among patients was asystole. In this regard, no significant difference was observed between successful and unsuccessful resuscitation processes. It was also observed that the success of resuscitation from 8 am to 4 pm was more than any other time period.

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Section: Discussionsupporting

confidence: 63%

Outcomes of cardiopulmonary resuscitation in the emergency department

Haghighi

Vahdati

Mahmoudie

et al. 2017

J Emerg Pract Trauma

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“…Oznacza to, że szansa na przeżycie po skutecznej resuscytacji jest większa niż w ogólnej populacji osób, u których dochodzi do NZK (54% v. 74,2%). Obserwacje te znajdują swoje potwierdzenie w innych pracach mówiących o skuteczności czynności resuscytacyjnych po wewnątrzszpitalnym NZK (52−62) i towarzyszącej śmiertelności szpitalnej (64−89) [11]. Ocena skuteczności resuscytacji w przypadku użycia innych kodów NZK niż I46.0 jest niemożliwa na podstawie danych zebranych w niniejszej pracy.…”

Section: Dyskusjaunclassified

“…Można to wyjaśnić szybkim rozpoznaniem NZK, szybszym podjęciem kwalifikowanych czynności resuscytacyjnych, niższym wiekiem pacjentów oraz faktem monitorowania czynności życio-wych w chwili wystąpienia NZK. Niektóre badania wskazują, że do 45% wszystkich przypadków wewnątrzszpitalnych zatrzymań krążenia ma miejsce na OIT [11]. Odsetek ten, w przypadku pacjentów leczonych na polskich OIT, jest na zbliżonym poziomie.…”

Section: Dyskusjaunclassified

Ocena częstości występowania wewnątrzszpitalnego nagłego zatrzymania krążenia w Polsce

Adamski¹,

Nowakowski²,

Goryński³

et al. 2016

Anaesthesiol Intensive Ther

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Background: In-hospital cardiac arrest with its poor prognosis is a challenging problem in hospitals. The aim of this study was to evaluate in Polish hospitals the frequency of in-hospital cardiac arrests with the subsequent mortality, with special emphasis on the type of unit at which the event occurred, and the patient's demographic data, such as age and sex. Methods: The study was a retrospective analysis of data for 2012 registered in the Polish General Hospital Morbidity Study. This research covered all Polish hospitals, excluding only government and psychiatric hospitals. The study inclusion criterion was the incidence of cardiac arrest in any hospital ward, recorded by the respective ICD-10 diagnosis code. Results: Of the 7,775,553 patients hospitalized, the diagnosis of cardiac arrest was reported in a total of 22,602 patients, which included 22,317 adults (98.7% of all patients) and 285 children (1.3%). Overall mortality after cardiac arrest among adults was 74.2%, and in children 46.7%. In both absolute numbers and as percentages of all documented cases, cardiac arrests occurred most often at the departments of intensive care, internal medicine, cardiology and emergency medicine. The accompanying mortal ity was lower than average at the departments of intensive care, cardiology, cardiology high dependency unit and emergency medicine. The median age of patients with cardiac arrest who died in the hospital was higher than the median age of those who survived (72 vs. 64; P < 0.05). Although cardiac arrests were reported more often among men than women (58.2% vs. 41.8%; P < 0.001), the hospital mortality was higher among women (79.2% vs. 71.6%; P < 0.001). Conclusion:The frequency of in-hospital cardiac arrests in Polish hospitals and the subsequent mortality is not substantially different from that observed in other countries. However, our study, based on ICD-10 diagnosis codes, gives only limited information about the patients and circumstances of this event. An in-depth analysis of the causes, prognoses, and outcome of in-hospital cardiac arrests could be facilitated by the creation of a national registry.

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“…For example, in the arrested and died category (typically involving an unaccompanied 'elderly' adult patient whose cardiac rhythm showed prolonged PEA or asystole), alignment of the trajectories was straightforward. When chronic and terminal illnesses exist, these are associated with much poorer outcomes (Stapleton et al, 2014: Cadogen, 2010) and persistent asystole for over twenty minutes despite ongoing ALS, in the absence of a reversible cause is considered reasonable grounds to stop resuscitation (Resuscitation Council (UK), 2015). These `subtacular' deaths were not preventable by the application of advanced medical technology and as noted by Bailey et al (2011), do not fit with the ethos of emergency care.…”

Section: Discussionmentioning

confidence: 99%

“…Survival rates for cardiac arrest outside of hospital are around 1% to 8% (Resuscitation Council (UK), 2015; Clarke, Lyon, Short, Crookston, & Clegg 2014; Herlitz et al, 2006) and fewer than 20% of patients arresting in hospital will survive to discharge (Stapleton, Ehlenbach, Deyo, & Curtis, 2014;Resuscitation Council (UK), 2011). Overall survival rates have not significantly changed for decades and are especially poor when associated with advanced chronic disease (British Medical Association (BMA), 2014; Gaieski, Abella, & Goyal, 2012).…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary resuscitation decisions in the emergency department: An ethnography of tacit knowledge in practice

Brummell

Seymour

Higginbottom

2016

Social Science & Medicine

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A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. AbstractDespite media images to the contrary, cardiopulmonary resuscitation in emergency departments is often unsuccessful. The purpose of this ethnographic study was to explore how health care professionals working in two emergency departments in the UK, make decisions to commence, continue or stop resuscitation. Data collection involved participant observation of resuscitation attempts and in-depth interviews with nurses, medical staff and paramedics who had taken part in the attempts. Detailed case examples were constructed for comparative analysis. Findings show that emergency department staff use experience and acquired tacit knowledge to construct a typology of cardiac arrest categories that help them navigate decision making. Categorisation is based on `less is more' heuristics which combine explicit and tacit knowledge to facilitate rapid decisions. Staff then work as a team to rapidly assimilate and interpret information drawn from observations of the patient's body and from technical, biomedical monitoring data. The meaning of technical data is negotiated during staff interaction. This analysis was informed by a theory of `bodily' and `technical' trajectory alignment that was first developed from an ethnography of death and dying in intensive care units. The categorisation of cardiac arrest situations and trajectory alignment are the means by which staff achieve consensus decisions and determine the point at which an attempt should be withdrawn. This enables them to construct an acceptable death in highly challenging circumstances.2

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

Abstract: BACKGROUND:Outcomes aft er in-hospital CPR in older adults with chronic illness are unclear.

Cited by 29 publications

References 32 publications

Outcomes of cardiopulmonary resuscitation in the emergency department

Outcomes of cardiopulmonary resuscitation in the emergency department

Ocena częstości występowania wewnątrzszpitalnego nagłego zatrzymania krążenia w Polsce

Cardiopulmonary resuscitation decisions in the emergency department: An ethnography of tacit knowledge in practice

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