Predicting survival, in-hospital cardiac arrests: resuscitation survival variables and training effectiveness.
OBJECTIVE
the purpose of this study was to determine the key factors influencing survival from cardiopulmonary resuscitation and to analyse the effectiveness of a resuscitation training programme.


METHODS
a prospective analysis of all cardiopulmonary resuscitation attempts was performed over a period of 3 years. Included in the study were 808 in hospital cardiac arrests, on whom a full cardiopulmonary resuscitation attempt was performed. Immediate, 24 h and discharge survival rates were the main outcome measures.


RESULTS
the immediate survival rate was 43.2%, then 30.2% at 24 h, and 21.9% by discharge. Multivariate analysis of all variables showed that the key factors influencing immediate survival were the 'duration of the arrest', the 'primary arrhythmia', 'basic life support within 3 min of an arrest', 'age less than 70 years', 'the primary mode of arrest-respiratory or cardiac' and 'difficulties with equipment and staff skills during a resuscitation'. Resuscitation training over the 3 year period was shown to have been effective, with improved survival rates on the wards and a reduced number of serious difficulties at arrests.


CONCLUSIONS
data collection and analysis of cardiopulmonary resuscitation attempts are essential for the formulation of survival indicators, and the subsequent training of resuscitation teams.
Cooper
S
S
Derriford Hospital, Plymouth, UK.
Cade
J
J
D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000193:education; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D010348:Patient Care Team; D010564:Personnel, Hospital / Q000193:education*; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome