PREDICTING IN-HOSPITAL MORTALITY DURING CARDIOPULMONARY-RESUSCITATION

On the average, 10-15% of patients who undergo cardiopulmonary resusci tation (CPR) following a cardiopulmonary arrest in the hospital enviro nment will survive to be discharged. The purpose of this study was to determine objective factors influencing patient outcome after CPR to d etermine who should be resuscitated and when to end CPR efforts. The r ecords of 266 patients who underwent in-hospital CPR over a 3-year per iod were retrospectively analyzed with regard to age, gender, co-morbi d conditions, setting of arrest, duration of resuscitation, initial pH and P-o2 during resuscitation, and outcome of resuscitative efforts. Twenty-four (9%) patients survived to be discharged from hospital. Eig hty-seven (33%) patients arrested in the intensive care unit, 77 (29%) on the ward, 91 (34%) in the emergency room, six (2%) in the cardiac catheterization laboratory and five (2%) in the operating room. There was no significant difference in Survival based on location of arrest. Factors associated with a poor prognosis included age greater than 60 , co-morbid disease (i.e. pneumonia, sepsis, renal failure, heart dise ase, etc.), an initial P-o2 < 50 mmHg and CPR efforts extending beyond 10 min. Based on this data, guidelines regarding initiation and termi nation of CPR should be instituted in light of poor outcome in patient s over 60 years of age with co-morbid conditions, specifically after 1 0 min of CPR.