title: Outcomes of In-Hospital Cardiopulmonary Resuscitation in Maintenance Dialysis Patients.
abstract: Outcomes of cardiopulmonary resuscitation (CPR) in hospitalized patients with ESRD requiring maintenance dialysis are unknown. Outcomes of in-hospital CPR in these patients were compared with outcomes in the general population using data from the Nationwide Inpatient Sample (NIS; 2005-2011). The study population included all adults (≥ 18 years old) from the general population and those with a history of ESRD. Baseline characteristics, in-hospital complications, and discharge outcomes were compared between the two groups. The effects of in-hospital CPR on mortality, length of stay, hospitalization charges, and discharge destination were analyzed. Yearly national trends in survival, discharge to home, and length of stay were also examined using the Cochran-Armitage trend test. During the study period, 56,069 patients with ESRD underwent in-hospital CPR compared with 323,620 patients from the general population. Unadjusted in-hospital mortality rates were higher in patients with ESRD (73.9% versus 71.8%, P<0.001) on univariate analysis. After adjusting for age, gender, and potential confounders, patients with ESRD had higher odds of mortality (odds ratio, 1.24; 95% confidence interval, 1.11 to 1.3; P<0.001). Survival after CPR improved in the year 2011 compared with 2005 (31% versus 21%, P<0.001). Multivariate analysis also revealed that a greater proportion of patients with ESRD who survived were discharged to skilled nursing facilities. In conclusion, outcomes after in-hospital CPR are improving in patients with ESRD but remain worse than outcomes in the general population. Patients with ESRD who survive are more likely to be discharged to nursing homes.
authors.affiliation: Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, Ohio; fahadsaeed20@gmail.com.
authors.forename: Fahad
authors.initials: F
authors.lastname: Saeed
authors.affiliation: Department of Neurology, Ochsner Clinic Foundation and Ochsner Neuroscience Institute, New Orleans, Louisiana;
authors.forename: Malik M
authors.initials: MM
authors.lastname: Adil
authors.affiliation: Zeenat Qureshi Stroke Institute, Saint Cloud, Minnesota;
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Malik
authors.affiliation: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio; and.
authors.forename: Jesse D
authors.initials: JD
authors.lastname: Schold
authors.affiliation: Department of Nephrology, University of Illinois at Urbana-Champaign and Carle Physicians' Group, Urbana, Illinois.
authors.forename: Jean L
authors.initials: JL
authors.lastname: Holley
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007676:Kidney Failure, Chronic / Q000191:economics / Q000401:mortality / Q000628:therapy*; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data / Q000639:trends; D006435:Renal Dialysis; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
keywords: cardiovascular; chronic dialysis; epidemiology and outcomes