Prospective analysis of outcome after cardiopulmonary resuscitation in critically ill surgical patients.
BACKGROUND
This study was done to examine the outcome of cardiopulmonary resuscitation (CPR) in the surgical intensive care unit (SICU) and to identify factors preceding cardiopulmonary arrest that could predict survival.


METHODS
We prospectively collected demographic, laboratory, diagnostic, and complications data in our SICU database on 5,237 consecutive patients and reviewed the charts of all patients receiving CPR.


RESULTS
Cardiopulmonary resuscitation was performed upon 1.1 percent (55 of 5,237 patients) of patients in the SICU. Twenty-nine percent (16 of 55 patients) survived greater than 24 hours but died in the hospital, and 13 percent (seven of 55 patients) survived to discharge. No patient with a worsening Glasgow Coma Scale (GCS) score, acute physiology score (APS), or any acute organ failure who had cardiopulmonary arrest survived. Survival after CPR for patients with a stable or improving APS was 32 percent (p < 0.01).


CONCLUSIONS
Patients in the SICU who survived CPR had a stable or improving clinical course as determined by APS and GCS score, and had not had acute organ failure. Patients who were critically ill with a declining clinical course did not survive after CPR.
Smith
D L
DL
Department of General Surgery, Wilford Hall United States Air Force Medical Center, Lackland, Air Force Base, Texas 78236-5300, USA.
Kim
K
K
Cairns
B A
BA
Fakhry
S M
SM
Meyer
A A
AA
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000401:mortality*; D016638:Critical Illness; D005260:Female; D015600:Glasgow Coma Scale; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D013514:Surgical Procedures, Operative