title: Duration of resuscitation efforts for in-hospital cardiac arrest by predicted outcomes: Insights from Get With The Guidelines - Resuscitation.
abstract: The duration of resuscitation efforts has implications for patient survival of in-hospital cardiac arrest (IHCA). It is unknown if patients with better predicted survival of IHCA receive longer attempts at resuscitation.
  
  
  
  In a multicenter observational cohort of 40,563 adult non-survivors of resuscitation efforts for IHCA between 2000 and 2012, we determined the pre-arrest predicted probability of survival to discharge with good neurologic status, categorized into very low (<1%), low (1-3%), average (>3%-15%), and above average (>15%). We then determined the association between predicted arrest survival probability and the duration of resuscitation efforts.
  
  
  
  The median duration of resuscitation efforts among all non-survivors was 19min (interquartile range 13-28min). Overall, the median duration of resuscitation efforts was longer in non-survivors with a higher predicted probability of survival with good neurologic status (median of 16, 17, 20, and 23min among the groups predicted to have very low, low, average, and above probabilities, respectively; P<0.001). However, the duration of resuscitation was often discordant with predicted survival, including longer than median duration of resuscitation efforts in 40.4% of patients with very low predicted survival and shorter than median duration of resuscitation efforts in 31.9% of patients with above average predicted survival.
  
  
  
  The duration of resuscitation efforts in patients with IHCA was generally consistent with their predicted survival. However, nearly a third of patients with above average predicted outcomes received shorter than average (less than 19min) duration of resuscitation efforts.
authors.affiliation: Minneapolis Heart Institute, Minneapolis, MN, United States(1). Electronic address: Steven.Bradley@allina.com.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Bradley
authors.affiliation: VA Eastern Colorado Health Care System, Denver, CO, United States; University of Colorado School of Public Health, Aurora, CO, United States.
authors.forename: Wenhui
authors.initials: W
authors.lastname: Liu
authors.affiliation: Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, MO, United States.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Chan
authors.affiliation: University of Iowa Carver College of Medicine, Iowa City, IA, United States.
authors.forename: Saket
authors.initials: S
authors.lastname: Girotra
authors.affiliation: University of Washington School of Medicine, Seattle, WA, United States.
authors.forename: Zachary D
authors.initials: ZD
authors.lastname: Goldberger
authors.affiliation: University of Colorado School of Medicine, Aurora, CO, United States.
authors.forename: Javier A
authors.initials: JA
authors.lastname: Valle
authors.affiliation: University of Colorado School of Medicine, Aurora, CO, United States.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Perman
authors.affiliation: University of Michigan Medical School, Ann Arbor, MI, United States.
authors.forename: Brahmajee K
authors.initials: BK
authors.lastname: Nallamothu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000401:mortality / Q000592:standards; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010347:Patient Care Planning / Q000458:organization & administration / Q000592:standards; D010351:Patient Discharge / Q000706:statistics & numerical data; D011379:Prognosis; D013223:Statistics as Topic; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: In-hospital cardiac arrest; Predicted outcomes; Resuscitation