Steven M Bradley1, Wenhui Liu2, Paul S Chan3, Saket Girotra4, Zachary D Goldberger5, Javier A Valle6, Sarah M Perman6, Brahmajee K Nallamothu7. 1. Minneapolis Heart Institute, Minneapolis, MN, United States(1). Electronic address: Steven.Bradley@allina.com. 2. VA Eastern Colorado Health Care System, Denver, CO, United States; University of Colorado School of Public Health, Aurora, CO, United States. 3. Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, MO, United States. 4. University of Iowa Carver College of Medicine, Iowa City, IA, United States. 5. University of Washington School of Medicine, Seattle, WA, United States. 6. University of Colorado School of Medicine, Aurora, CO, United States. 7. University of Michigan Medical School, Ann Arbor, MI, United States.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. Published by Elsevier B.V.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. Published by Elsevier B.V.
Authors: Laurie J Morrison; Gerald Kierzek; Douglas S Diekema; Michael R Sayre; Scott M Silvers; Ahamed H Idris; Mary E Mancini Journal: Circulation Date: 2010-11-02 Impact factor: 29.690
Authors: R O Cummins; D Chamberlain; M F Hazinski; V Nadkarni; W Kloeck; E Kramer; L Becker; C Robertson; R Koster; A Zaritsky; L Bossaert; J P Ornato; V Callanan; M Allen; P Steen; B Connolly; A Sanders; A Idris; S Cobbe Journal: Circulation Date: 1997-04-15 Impact factor: 29.690
Authors: Mary Ann Peberdy; William Kaye; Joseph P Ornato; Gregory L Larkin; Vinay Nadkarni; Mary Elizabeth Mancini; Robert A Berg; Graham Nichol; Tanya Lane-Trultt Journal: Resuscitation Date: 2003-09 Impact factor: 5.262
Authors: Zachary D Goldberger; Paul S Chan; Robert A Berg; Steven L Kronick; Colin R Cooke; Mingrui Lu; Mousumi Banerjee; Rodney A Hayward; Harlan M Krumholz; Brahmajee K Nallamothu Journal: Lancet Date: 2012-09-05 Impact factor: 79.321
Authors: Gina M Piscitello; Esha M Kapania; Anthony Kanelidis; Mark Siegler; William F Parker Journal: J Pain Symptom Manage Date: 2020-12-17 Impact factor: 5.576