A decade of in-hospital resuscitation: outcomes and prediction of survival?

OBJECTIVE: To provide survival rates and associated factors from a 10-year study of in-hospital cardiopulmonary resuscitation (CPR). DESIGN: Longitudinal prospective case register study of all adult in-hospital CPR attempts conducted from April 1993 to March 2003. SETTING: 1200-bed general hospital in Plymouth (UK). PATIENTS: 2121 adult in-hospital CPR attempts in Derriford Hospital, Plymouth during the period April 1993-March 2003. MAIN OUTCOME MEASURES: Immediate, 24 h, hospital discharge and 12 month survival rates. RESULTS: Following CPR the immediate survival rate (95% confidence interval (C.I.)) was 38.6% (36.5, 40.7), then 24.7% (22.8, 26.6) at 24 h, 15.9% (14.4, 17.6) at discharge and 11.3% (10.0, 12.7) at 12 months. The primary arrhythmia, age, duration of arrest and time of arrest were strongly related to survival at 24 h and discharge. There were very low survival rates for pulse-less electrical activity (PEA) and asystole compared to VT/VF arrests; survival rates were highest for those less than 60 years and decreased with increasing age. The longer the resuscitation the less the survival, and those who arrested at night were less likely to survive. The primary arrest, respiratory or cardiac, was also independently associated with survival at 24 h but not with hospital discharge. Sex and the commencement of basic life support (BLS) within 3 min was not an independent predictor of survival. CONCLUSION: The findings of this study show resuscitation survival rates from a 10-year study and indicate some of the key predictors of survival.