PROSPECTIVE ANALYSIS OF OUTCOME AFTER CARDIOPULMONARY-RESUSCITATION IN CRITICALLY ILL SURGICAL PATIENTS

BACKGROUND: This study was done to examine the outcome of cardiopulmon ary resuscitation (CPR) in the surgical intensive care unit (SICU) and to identify factors preceding cardiopulmonary arrest that could predi ct survival, STUDY DESIGN: We prospectively collected demographic, lab oratory, diagnostic, and complications data in our SICU database on 5, 237 consecutive patients and reviewed the charts of ah patients receiv ing CPR, RESULTS: Cardiopulmonary resuscitation was performed upon 1.1 percent (55 of 5,237 patients) of patients in the SICU, Twenty-nine p ercent (16 of 55 patients) survived greater than 24 hours but died in the hospital, and 13 percent (seven of 55 patients) survived to discha rge, No patient with a worsening Glasgow Coma Scale (GCS) score, acute physiology score (APS), or any acute organ failure who had cardiopulm onary arrest survived, Survival after CPR for patients with a stable o r improving APS was 32 percent (p<0.01). CONCLUSIONS: Patients in the SICU who survived CPR had a stable or improving clinical course as det ermined by APS and GCS score and had not had acute organ failure. Pati ents who were critically ill with a declining clinical course did not survive after CPR.