Cardiopulmonary resuscitation: outcome and its predictors among hospitalized adult patients in Pakistan.
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.
Khan
Nadeem Ullah
NU
Department of Medicine, Aga Khan University Hospital, Karachi, 74800, Pakistan.
Razzak
Junaid A
JA
Ahmed
Humaid
H
Furqan
Muhammad
M
Saleem
Ali Faisal
AF
Alam
Hammad
H
ul Huda
Anwar
A
Khan
Uzma Rahim
UR
Rehmani
Rifat
R