title: Cardiopulmonary resuscitation: outcome and its predictors among hospitalized adult patients in Pakistan.
abstract: BACKGROUND
  Our aim was to study the outcomes and predictors of in-hospital cardiopulmonary resuscitation (CPR) among adult patients at a tertiary care centre in Pakistan.
  
  
  METHODS
  We conducted a retrospective chart review of all adult patients (age > or =14 years), who underwent CPR following cardiac arrest, in a tertiary care hospital during a 5-year study period (June 1998 to June 2003). We excluded patients aged 14 years or less, those who were declared dead on arrival and patients with a "do not resuscitate" order. The 1- and 6-month follow-ups of discharged patients were also recorded.
  
  
  RESULTS
  We found 383 cases of adult in-hospital cardiac arrest that underwent CPR. Pulseless electrical activity was the most common initial rhythm (50%), followed by asystole (30%) and ventricular tachycardia/fibrillation (19%). Return of spontaneous circulation was achieved in 72% of patients with 42% surviving more than 24 h, and 19% survived to discharge from hospital. On follow-up, 14% and 12% were found to be alive at 1 and 6 months, respectively. Multivariable logistic regression identified three independent predictors of better outcome (survival >24 h): non-intubated status [adjusted odds ratio (aOR): 3.1, 95% confidence interval (CI): 1.6-6.0], location of cardiac arrest in emergency department (aOR: 18.9, 95% CI: 7.0-51.0) and shorter duration of CPR (aOR: 3.3, 95% CI: 1.9-5.5).
  
  
  CONCLUSIONS
  Outcome of CPR following in-hospital cardiac arrest in our setting is better than described in other series. Non-intubated status before arrest, cardiac arrest in the emergency department and shorter duration of CPR were independent predictors of good outcome.
authors.affiliation: Department of Medicine, Aga Khan University Hospital, Karachi, 74800, Pakistan.
authors.forename: Nadeem Ullah
authors.initials: NU
authors.lastname: Khan
authors.forename: Junaid A
authors.initials: JA
authors.lastname: Razzak
authors.forename: Humaid
authors.initials: H
authors.lastname: Ahmed
authors.forename: Muhammad
authors.initials: M
authors.lastname: Furqan
authors.forename: Ali Faisal
authors.initials: AF
authors.lastname: Saleem
authors.forename: Hammad
authors.initials: H
authors.lastname: Alam
authors.forename: Anwar
authors.initials: A
authors.lastname: ul Huda
authors.forename: Uzma Rahim
authors.initials: UR
authors.lastname: Khan
authors.forename: Rifat
authors.initials: R
authors.lastname: Rehmani