title: Outcomes of In-Hospital Cardiopulmonary Resuscitation in Patients with CKD.
abstract: Advance care planning, including code/resuscitation status discussion, is an essential part of the medical care of patients with CKD. There is little information on the outcomes of cardiopulmonary resuscitation in these patients. We aimed to measure cardiopulmonary resuscitation outcomes in these patients.
  
  
  
  Our study is observational in nature. We compared the following cardiopulmonary resuscitation-related outcomes in patients with CKD with those in the general population by using the Nationwide Inpatient Sample (2005-2011): (1) survival to hospital discharge, (2) discharge destination, and (3) length of hospital stay. All of the patients were 18 years old or older.
  
  
  
  During the study period, 71,961 patients with CKD underwent in-hospital cardiopulmonary resuscitation compared with 323,620 patients from the general population. Unadjusted in-hospital mortality rates were higher in patients with CKD (75% versus 72%;P<0.001) on univariate analysis. After adjusting for age, sex, and potential confounders, patients with CKD had higher odds of mortality (odds ratio, 1.24; 95% confidence interval, 1.11 to 1.34;P≤0.001) and length of stay (odds ratio, 1.11; 95% confidence interval, 1.07 to 1.15;P=0.001). Hospitalization charges were also greater in patients with CKD. There was no overall difference in postcardiopulmonary resuscitation nursing home placement between the two groups. In a separate subanalysis of patients ≥75 years old with CKD, higher odds of in-hospital mortality were also seen in the patients with CKD (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.17;P=0.01).
  
  
  
  In conclusion, we observed slightly higher in-hospital mortality in patients with CKD undergoing in-hospital cardiopulmonary resuscitation.
authors.affiliation: Divisions of Nephrology and Hypertension and.|Palliative Care, University of Rochester, Rochester, New York.
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: Office of Clinical Informatics, Texas Tech University, El Paso, Texas.
authors.forename: Umar M
authors.initials: UM
authors.lastname: Kaleem
authors.affiliation: Department of Neurology, Zeenat Qureshi Stroke Institute, St. Cloud, Minnesota.
authors.forename: Taqi T
authors.initials: TT
authors.lastname: Zafar
authors.affiliation: Department of Emergency Medicine, Shifa International Hospital, Islamabad, Pakistan.
authors.forename: Abdus Salam
authors.initials: AS
authors.lastname: Khan
authors.affiliation: Department of Internal Medicine, University of Illinois, Urbana-Champaign, Illinois.|Nephrology Division, Carle Physician Group, Urbana, Illinois; and.
authors.forename: Jean L
authors.initials: JL
authors.lastname: Holley
authors.affiliation: Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Nally
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D016022:Case-Control Studies; D005260:Female; D006323:Heart Arrest / Q000150:complications* / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data*; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Advance Care Planning; Cardiopulmonary Resuscitation; Hospital Mortality; Humans; Inpatients; Length of Stay; Nursing Homes; Patient Discharge; Renal Insufficiency, Chronic; cardiovascular; chronic kidney disease; outcomes