title: Selective application of cardiopulmonary resuscitation improves survival rates.
abstract: This study is a retrospective review of all patients who died without cardiopulmonary resuscitation (CPR) or who sustained a sudden cardiopulmonary arrest in the hospital and received CPR during a 2-yr period at a large medical center. Based on a review of Current Procedural Terminology codes, patients were classified into one of the ten disease categories: multiple medical problems, acute disease, procedure-related, congenital disease, neoplasm, metastatic neoplasm, trauma, burn, acquired immunodeficiency syndrome, and dementia. A total of 1206 patient deaths without a CPR effort were identified. CPR was administered to another 550 patients who had a sudden cardiopulmonary arrest, of which 71% survived the resuscitative attempt initially, but only 25% survived CPR until discharge from the hospital. CPR was applied less frequently than the mean in the metastatic neoplasm (P < 0.0001), trauma (P = 0.013), and dementia (P = 0.0003) groups and more frequently in the acute disease (P < 0.0001) and procedure-related (P < 0.0001) groups. Survival to discharge from the hospital was more frequent than the mean in the congenital disease group (P = 0.0004) and less frequent in the neoplasm group (P = 0.0425). The other groups had survival rates comparable to the mean. Patients 70 yr of age and older were less likely to receive CPR than those younger than 70 (P < 0.0001). However, if they did receive CPR, they were just as likely to survive to discharge from the hospital as the younger patients (P = 0.3404).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Anesthesiology, University of Virginia Health Sciences Center, Charlottesville 22908.
authors.forename: K J
authors.initials: KJ
authors.lastname: Schwenzer
authors.forename: W T
authors.initials: WT
authors.lastname: Smith
authors.forename: C G
authors.initials: CG
authors.lastname: Durbin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D002648:Child; D002675:Child, Preschool; D006323:Heart Arrest / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate