title: Multiple in-hospital resuscitation efforts in the elderly.
abstract: OBJECTIVE
  The objective of this study was to determine the characteristics and survival rates of patients receiving cardiopulmonary resuscitation more than once during a single hospitalization.
  
  
  METHODS
  We analyzed inpatient Medicare data from 1992 to 2005 identifying beneficiaries 65 years old and older who underwent cardiopulmonary resuscitation more than once during the same hospitalization.
  
  
  METHODS
  We examined patient and hospital characteristics, survival to hospital discharge, factors associated with survival to discharge, median survival, and discharge disposition.
  
  
  RESULTS
  We analyzed data from 421,394 patients who underwent cardiopulmonary resuscitation during the study period. Four lakh thirteen thousand four hundred three patients received cardiopulmonary resuscitation once during a hospitalization and survival was 17.7% with median survival after discharge being 20.6 months. There were 7,991 patients who received cardiopulmonary resuscitation more than once during the same hospitalization; 8.8% survived the efforts, and median survival after leaving the hospital was 10.5 months. Patients who received more than one episode of cardiopulmonary resuscitation during a hospitalization were significantly less likely to go home after discharge. Greater age, black race, higher burden of chronic illness, and receiving cardiopulmonary resuscitation in a larger or metropolitan hospital were associated with lower survival among patients receiving cardiopulmonary resuscitation more than once.
  
  
  CONCLUSIONS
  Undergoing multiple cardiopulmonary resuscitation events during a hospitalization is associated with substantially reduced short- and long-term survival compared with patients who undergo cardiopulmonary resuscitation once. This information may be useful to clinicians when discussing end-of-life care with patients and families of patients who have experienced return of spontaneous circulation following in-hospital cardiopulmonary resuscitation but remain at risk for recurrent cardiac arrest.
authors.affiliation: 1University of Vermont, Burlington, VT. 2University of Wisconsin School of Medicine and Public Health, Madison, WI. 3Medical University of South Carolina, Charleston, SC.
authors.forename: Prema R
authors.initials: PR
authors.lastname: Menon
authors.forename: William J
authors.initials: WJ
authors.lastname: Ehlenbach
authors.forename: Dee W
authors.initials: DW
authors.lastname: Ford
authors.forename: Renee D
authors.initials: RD
authors.lastname: Stapleton
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000401:mortality* / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D012307:Risk Factors