Online CPR Certification Blog
Poor survival in in-hospital CPR
Date: September 19th, 2013
The death rate resulting from patients who received in-house cardiopulmonary resuscitation has increased. The same negative effect has been portrayed in a drop on the rate of survivors being released from hospitals after going through CPR procedures. This was reported by the William J. Ehlenbach (University of Washington) and colleagues.
The researchers have said that these results have emerged at a time when a lot of energy is being put in spreading awareness through education. It all concerns the limits of CPR when performing it to the critically sick victims with life-threatening illnesses. They added that to date, it still continued to be unclear if significant improvements in CPR have led to a positive move towards the outcomes on patients undergoing in-hospital cardiac arrest.
In conducting proper assessment, the researchers had to dig deep into the fee-for-service Medicare raw data for the period 1992 to 2005. Data obtained involved 433,985 patients that constituted of elderly patients from the age of 65 and above. These patients had undergone CPR procedure while they suffered in-hospital cardiac arrest in the U.S. medical facilities.
In the same patients, 18.3% were able to survive to the level of being discharged to go home. This, according to the researchers, did not portray a major movement in the percentage change over the selected period of time. As clearly reported, it remained at 2.73 events per 1,000 admissions over the research period.
The researchers also noticed that in-hospital deaths generally increased after the patients had been passed through CPR. A 37% increase was reported over the research period with the year 1992 having 3.8% and 2005 ending with a high of 5.2%.
Reason that may explain such happenings
It was explained that illness became more severe as time moved, and the causes and individual patient arrest pattern had too changed over time. It was also added that the attempts to better the delivery of cardiopulmonary resuscitation out of the medical facilities are different from the in-hospital settings.
General findings among various classes of patients
According to the research done, there seemed to be a lower survival rate among males, elderly individuals and those patients that had coexisting disease.
In an unexpected way, the researchers found out that the patients who had CPR from smaller hospitals had more survival rate. The black patients undergoing in-hospital CPR were 23.6% lower compared to the white patients. To explain the race, the researchers pointed out that blacks have a higher probability to have CPR in hospital, but having a poor survival rate after the CPR.
It was also seen that the portion of patients who made it through CPR and were discharged home, reduced over the research period. The researchers said that this reflected poor neurological outcomes.
In the end, they concluded that their research was limited by is dependency on ICD-9 codes. Also it was unable to do an evaluation on longer term outcomes.