Frailty, multimorbidity and in-hospital cardiopulmonary resuscitation: predictable markers of outcome?

BACKGROUND: This study's aim was to investigate an association between outcome from in-hospital cardiopulmonary resuscitation (CPR) and increasing burden of comorbidities and frailty.
METHODS: Retrospective analysis of prospectively collected data from contemporaneous patient notes and electronic records of all patients who suffered an in-hospital cardiac arrest between 1 April 2017 and 31 March 2018 in a hospital that includes a tertiary cardiology department.
RESULTS: A total of 113 patient records were assessed. Patient frailty was assessed based on calculation of Rockwood clinical frailty score (CFS) and comorbidity assessment based on Charlson comorbidity index (CCI). A linear correlation has been identified between increasing CCI and reduced survival (ANOVA = p<0.001) and rates of return of spontaneous circulation (ROSC) (ANOVA = 0.013). No patients with a CFS above 6 survived to 1 year. A linear correlation was identified between increasing CFS and reduced probability of ROSC (ANOVA p=0.002), survival to discharge (ANOVA p=0.003) and 1 year (ANOVA p=0.001).
CONCLUSION: Our findings suggest an association between increasing patient multimorbidity and frailty and poorer outcome post cardiac arrest. © Royal College of Physicians 2021. All rights reserved.