[Cardiopulmonary resuscitation in hospitalized patients in conventional units. Prospective study of 356 consecutive cases. Commission for Care of Cardiorespiratory Arrest].
BACKGROUND
Information regarding to the system functioning and to the outcome of patients in whom cardiopulmonary resuscitation (CPR) was performed during their in hospital period in non intensive care units are essentially lacking in Spain. The objectives of the present work were: 1) to define clinical and demographic characteristics of the patients who develop cardiopulmonary arrest in general hospitalization wards; 2) to analyze immediate and late (at discharge) survival rates as well as the frequency of severe sequelae in final survivors; 3) to identify prognostic factors in relationship to survival, and 4) to detect possible internal deficiencies in the organized system of CPR.


METHODS
All patients who develop cardiac and pulmonary arrest through their hospitalization in general wards during a three year period, were prospectively included. Clinical and demographic data from all the patients as well as data related to the internal functioning of the system were recorded.


RESULTS
From 356 included cases, 196 (55%) were initially recovered and 128 (36%) were discharged from the hospital. Among the latter group, 12.5% remained with severely disabling neurologic damage. Age under 80 years, resuscitation maneuvers for less than 20 minutes and respiratory arrest as the ultimate event leading to cardiopulmonary arrest were associated with better prognosis. The internal deficiencies most commonly recorded in the system were false calling to the emergency team, the wrong identification of the location in the hospitalization unit and several abnormalities in the content of CPR sets.


CONCLUSIONS
With the currently available organized system directed towards CPR for patients admitted in general hospitalization wards, our rates of success are good and similar to those achieved in some intensive care units. Thus, a similar policy may be encouraged in large hospitals. Since most of the detected deficiencies in internal functioning are easy to rectify, a close monitoring is warranted in order to optimize the results.
Fontanals
J
J
Servicio de Anestesiología y Reanimación, Hospital Clínic i Provincial, Barcelona.
Miró
O
O
Pastor
X
X
Grau
J M
JM
Torres
A
A
Zavala
E
E
D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies
Reanimación cardiopulmonar en enfermos hospitalizados en unidades convencionales. Estudio prospectivo de 356 casos consecutivos. Comisión de Atención al Paro Cardiorrespiratorio.