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Survival after in-hospital cardiopulmonary resuscitation

A meta-analysis

Journal of General Internal Medicine volume 13, pages 805–816 (1998)Cite this article

Abstract

OBJECTIVE: To determine the rates of immediate survival and survival to discharge for adult patients undergoing in-hospital cardiopulmonary resuscitation, and to identify demographic and clinical variables associated with these outcomes.

MEASUREMENTS AND MAIN RESULTS: The MEDLARS database of the National Library of Medicine was searched. In addition, the authors’ extensive personal files and the bibliography of each identified study were searched for further studies. Two sets of inclusion criteria were used, minimal (any study of adults undergoing in-hospital cardiopulmonary resuscitation) and strict (included only patients from general ward and intensive care units, and adequately defined cardiopulmonary arrest and resuscitation). Each study was independently reviewed and abstracted in a nonblinded fashion by two reviewers. The data abstracted were compared, and any discrepancies were resolved by consensus discussion. For the subset of studies meeting the strict criteria, the overall rate of immediate survival was 40.7% and the rate of survival to discharge was 13.4%. The following variables were associated with failure to survive to discharge: sepsis on the day prior to resuscitation (odds ratio [OR] 31.3; 95% confidence interval [CI] 1.9, 515), metastatic cancer (OR 3.9; 95% CI 1.2, 12.6), dementia (OR 3.1; 95% CI 1.1, 8.8), African-American race (OR 2.8; 95% CI 1.4, 5.6), serum creatinine level at a cutpoint of 1.5 mg/dL (OR 2.2; 95% CI 1.2, 3.8), cancer (OR 1.9; 95% CI 1.2, 3.0), coronary artery disease (OR 0.55; 95% CI 0.4, 0.8), and location of resuscitation in the intensive care unit (OR 0.51; 95% CI 0.4, 0.8).

CONCLUSIONS: When talking with patients, physicians can describe the overall likelihood of surviving discharge as 1 in 8 for patients who undergo cardiopulmonary resuscitation and 1 in 3 for patients who survive cardiopulmonary resuscitation.

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Author information

Affiliations

  1. Department of Family Practice, Michigan State University, B101 Clinical Center, 48824-1315, East Lansing, MI

    Mark H. Ebell MD, MS & Henry C. Barry MD, MS

  2. Department of Family Medicine, SUNY Health Science Center, Syracuse, N.Y.

    Lorne A. Becker MD

  3. Department of Family Practice, University of Kentucky, Lexington, KY

    Michael Hagen MD

Authors
  1. Mark H. Ebell MD, MS
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  2. Lorne A. Becker MD
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  3. Henry C. Barry MD, MS
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  4. Michael Hagen MD
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Ebell, M.H., Becker, L.A., Barry, H.C. et al. Survival after in-hospital cardiopulmonary resuscitation. J GEN INTERN MED 13, 805–816 (1998). https://doi.org/10.1046/j.1525-1497.1998.00244.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.1998.00244.x

Key Words

  • cardiopulmonary resuscitation
  • meta-analysis
  • resuscitation
  • prognosis