CARDIOPULMONARY-RESUSCITATION IN PATIENTS ADMITTED IN GENERAL HOSPITALIZATION - A PROSPECTIVE-STUDY OF 356 CONSECUTIVE CASES

BACKGROUND: Information regarding to the system functioning and to the outcome of patients in whom cardiopulmonary resuscitation (CPR) was p erformed during their in hospital period in non intensive care units a re essentially lacking in Spain. The objectives of the present work we re: 1) to define clinical and demographic characteristics of the patie nts who develop cardiopulmonary arrest in general hospitalization ward s; 2) to analyze immediate and late (at discharge) survival rates as w ell as the frequency of severe sequelae in final survivors; 3) to iden tify prognostic factors in relationship to survival, and 4) to detect possible internal deficiencies in the organized system of CPR, PATIENT S AND METHODS: All patients who develop cardiac and pulmonary arrest t hrough their hospitalization in general wards during a three year peri od, were prospectively included. Clinical and demographic data from al l the patients as well as data related to the internal functioning of the system were recorded,RESULTS: From 356 included cases, 196 (55%) w ere initially recovered and 128 (36%) were discharged from the hospita l. Among the latter group, 12.5% remained with severely disabling neur ologic damage. Age under 80 years, resuscitation maneuvers for less th an 20 minutes and respiratory arrest as the ultimate event leading to cardiopulmonary arrest were associated with better prognosis. The inte rnal deficiencies most commonly recorded in the system were false call ing to the emergency team, the wrong identification of the location in the hospitalization unit and several abnormalities in the content of CPR sets. CONCLUSIONS: With the currently available organized system d irected towards CPR for patients admitted in general hospitalization w ards, our rates of succes are good and similar to those achieved in so me intensive care units. Thus, a similar policy may be encouraged in l arge hospitals. Since most of the detected deficiencies in internal fu nctioning are easy to rectify, a close monitoring is warranted in orde r to optimize the results.