Cardiopulmonary resuscitation on the general ward: no category of patients should be excluded in advance.
In this study 91 consecutive CPR cases in 90 patients on general wards were evaluated during 18 months. Fifteen patients (16.5%) could be discharged, which is relatively favourable in comparison to the literature. Children proved to have a better chance to leave the hospital alive than adults (6/18 vs. 9/72; P less than 0.05). No factors with negative predictive value before the cardiopulmonary arrest could be isolated. Even oncological patients, often described as a prognostically poor category, with a success rate of 27% (6/22) did not differ from other categories. Patients with isolated respiratory arrest, ventricular tachycardia or ventricular fibrillation at the arrival of the CPR-team had a better chance to be discharged from the hospital. A rapid decrease in survival was noted if a CPR attempt lasted longer than 10 min (P less than 0.001). When there is no return of vital signs within 30 min the CPR attempt can be stopped. During follow-up period (mean 6 month) 2 of the 15 survivors (13.3%) died from a non-cardiopulmonary cause. It is concluded that no category of patients can be excluded from CPR in advance. Although ultimate success rate for CPR in the general wards will rarely exceed 15%, CPR has to be initiated in most cases of cardiopulmonary arrest.
Hendrick
J M
JM
St. Radboud Hospital, Department of Cardiology, Nijmegen, The Netherlands.
Pijls
N H
NH
van der Werf
T
T
Crul
J F
JF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004630:Emergencies; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000401:mortality; D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010348:Patient Care Team / Q000458:organization & administration; D018579:Patient Selection; D010362:Patients' Rooms; D011379:Prognosis; D012151:Resuscitation; D012189:Retrospective Studies; D015996:Survival Rate; D028761:Withholding Treatment