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Comparative Study
. 2014 Dec;3(6):e001044.
doi: 10.1161/JAHA.114.001044.

Age, sex, and hospital factors are associated with the duration of cardiopulmonary resuscitation in hospitalized patients who do not experience sustained return of spontaneous circulation

Abigail M Khan  1 , James N Kirkpatrick, Lin Yang, Peter W Groeneveld, Vinay M Nadkarni, Raina M Merchant; American Heart Association’s Get With the Guidelines-Resuscitation (GWTG-R) Investigators
Collaborators, Affiliations
Comparative Study

Age, sex, and hospital factors are associated with the duration of cardiopulmonary resuscitation in hospitalized patients who do not experience sustained return of spontaneous circulation

Abigail M Khan et al. J Am Heart Assoc. 2014 Dec.

Abstract

Background: Variability in the duration of attempted in‐hospital cardiopulmonary resuscitation (CPR) is high, but the factors influencing termination of CPR efforts are unknown.

Methods and results: We examined the association between patient and hospital characteristics and CPR duration in 45 500 victims of in‐hospital cardiac arrest who did not experience return of spontaneous circulation (ROSC) and who were enrolled in the Get With the Guidelines registry between 2001 and 2010. In a secondary analysis, we performed analyses in 46 168 victims of in‐hospital cardiac arrest who experienced ROSC. We used ordered logistic regression to identify factors associated with CPR duration. Analyses were conducted by tertile of CPR duration (tertiles: ROSC group: 2 to 7, 8 to 17, and 18 to 120 minutes; no‐ROSC group: 2 to 16, 17 to 26, 27 to 120 minutes). In those without ROSC, younger age (aged 18 to 40 versus >65 years; odds ratio [OR] 1.81; 95% CI 1.69 to 1.95; P<0.001), female sex (OR 1.05; 95% CI 1.02 to 1.09; P=0.005), ventricular tachycardia or fibrillation (OR 1.50; 95% CI 1.42 to 1.58; P<0.001), and the need to place an invasive airway (OR 2.59; 95% CI 2.46 to 2.72; P<0.001) were associated with longer CPR duration. In those with ROSC, ventricular tachycardia or fibrillation (OR 0.89; 95% CI 0.85 to 0.93; P<0.001) and witnessed events (OR 0.87; 95% CI 0.82 to 0.91; P<0.001) were associated with shorter duration.

Conclusions: Age and sex were associated with attempted CPR duration in patients who do not experience ROSC after in‐hospital cardiac arrest but not in those who experience ROSC. Understanding the mechanism of these interactions may help explain variability in outcomes for in‐hospital cardiac arrest.

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Figures

Figure 1.
Figure 1.
Study cohort with associated inclusion and exclusion variables. ICD indicates implantable cardioverter‐defibrillator; IHCA, in‐hospital cardiac arrest.
Figure 2.
Figure 2.
Distribution of cardiopulmonary resuscitation duration. The y‐axis represents the frequency of occurrences, and the x‐axis represents the median duration of the resuscitation event. A, Patients who did not experience ROSC after IHCA. B, Patients who experienced ROSC after IHCA. IHCA indicates in‐hospital cardiac arrest; ROSC, return of spontaneous circulation.
See this image and copyright information in PMC

Comment in

References

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