TY - JOUR
T1 - Survival and functional outcomes after cardiopulmonary resuscitation in the intensive care unit
AU - Gershengorn, Hayley B.
AU - Li, Guohua
AU - Kramer, Andrew
AU - Wunsch, Hannah
N1 - Funding Information:
Sources of financial support: None.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2012/8
Y1 - 2012/8
N2 - Purpose: Comparatively less is known about the outcomes of cardiopulmonary resuscitation (CPR) in patients in the intensive care unit (ICU) compared with those not in an ICU. In this study, we evaluated survival rates, functional status, and predictors of good outcomes after in-ICU CPR. Methods: We used the Project IMPACT (Cerner Corporation, Kansas City, Mo) database to conduct a retrospective cohort study of adults who underwent in-ICU CPR in the United States from 2001 to 2008. We characterized survival rates and functional outcomes and identified predictors of better prognosis using multivariate logistic regression analyses. Results: Of 362074 ICU admissions, 6518 (1.8%) received in-ICU CPR with 15.7% (n = 1025) surviving to hospital discharge. Survival decreased with age, more comorbidities, and for certain admitting diagnoses, such as sepsis. Patients who survived incurred significant functional morbidity. Of survivors, only 33.6% were discharged home, and only 20.1% were functionally independent on hospital discharge. A total of 63.4% had a decrease in functional status compared with admission. Only 3.3% of all patients (21.7% of survivors) were both functionally independent and discharged home ("optimal" functional outcome). Among survivors, the risk-adjusted odds of having an optimal functional outcome decreased with age (P ≤ .022) and with failure of 3 or more organs during ICU stay (P = .006). Conclusions: Only 1 of 6 adults receiving in-ICU CPR survives to hospital discharge, and less than 5% are discharged home with independent function. Among survivors, most show large decreases in functional status compared with hospital admission.
AB - Purpose: Comparatively less is known about the outcomes of cardiopulmonary resuscitation (CPR) in patients in the intensive care unit (ICU) compared with those not in an ICU. In this study, we evaluated survival rates, functional status, and predictors of good outcomes after in-ICU CPR. Methods: We used the Project IMPACT (Cerner Corporation, Kansas City, Mo) database to conduct a retrospective cohort study of adults who underwent in-ICU CPR in the United States from 2001 to 2008. We characterized survival rates and functional outcomes and identified predictors of better prognosis using multivariate logistic regression analyses. Results: Of 362074 ICU admissions, 6518 (1.8%) received in-ICU CPR with 15.7% (n = 1025) surviving to hospital discharge. Survival decreased with age, more comorbidities, and for certain admitting diagnoses, such as sepsis. Patients who survived incurred significant functional morbidity. Of survivors, only 33.6% were discharged home, and only 20.1% were functionally independent on hospital discharge. A total of 63.4% had a decrease in functional status compared with admission. Only 3.3% of all patients (21.7% of survivors) were both functionally independent and discharged home ("optimal" functional outcome). Among survivors, the risk-adjusted odds of having an optimal functional outcome decreased with age (P ≤ .022) and with failure of 3 or more organs during ICU stay (P = .006). Conclusions: Only 1 of 6 adults receiving in-ICU CPR survives to hospital discharge, and less than 5% are discharged home with independent function. Among survivors, most show large decreases in functional status compared with hospital admission.
KW - Cardiopulmonary resuscitation
KW - Critical illness
KW - Functional status
KW - Hospital mortality
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U2 - 10.1016/j.jcrc.2011.11.001
DO - 10.1016/j.jcrc.2011.11.001
M3 - Article
C2 - 22227081
AN - SCOPUS:84864147117
SN - 0883-9441
VL - 27
SP - 421.e9-421.e17
JO - Journal of Critical Care
JF - Journal of Critical Care
IS - 4
ER -