Evaluation of in-Hospital Cardiopulmonary Resuscitation

ABSTRACT

BACKGROUND: Cardiopulmonary resuscitation (CPR) has been practised since the introduction of external cardiac massage in 1960. Observed results of in-hospital CPR in many published studies vary greatly. Data on survival has called attention to patient-related factors, lack of medical personnel training and delay in initiation of CPR. We evaluated the results of CPR attempted in a single institute in Korea. SUBJECTS: Our subjects were patients in whom CPR was instituted in our hospital with activation of the emergency call system between August 1, 1995 and December 31, 1997 (n=308, M=181, F=127, mean age=47.8+/-26.4 years). RESULTS: One hundred and ninety-eight among the 308 cases of in-hospital CPR were reviewed, excluding preventive CPR cases and CPR performed on subjects designated DNAR (Do not attempt resuscitation). Mechanism of arrest were respiraory arrest in 84 cases (42.4%), ventricular tachycardia/fibrillation in 59 (29.8%), asytole in 52 (26.3%), and electromechanical dissocaition in 3 (1.5%) in order of declining frequency. Overall survival rate at discharge was 12.6%. Among different age groups, the rates were21.6% in the pediatric group (age or = 70). Survival outcomes associated with mechanism of arrest were11.9% for respiratory arrest, 15.3% for ventricular tachycardia/fibrillation and 9.6% for asystole. No significant difference in survival was found between mechanisms of arrest. Successful outcome after CPR was significantly associated with CPR duration, showing higher wurvival rates with CPR performed for less than 15 minutes than over 15 minutes (p<0.001). CONCLUSION: Among in-hospital CPR cases, only 12.6% survive to discharge. We suggest that guidelines for performing and evaluating in-hospital CPR should be set up to improve the survival rate.