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Review
. 2014 Dec 1;14(15):1-38.
eCollection 2014.

Cardiopulmonary Resuscitation in Patients With Terminal Illness: An Evidence-Based Analysis

S Sehatzadeh
Review

Cardiopulmonary Resuscitation in Patients With Terminal Illness: An Evidence-Based Analysis

S Sehatzadeh. Ont Health Technol Assess Ser. .

Abstract

Background: Cardiopulmonary resuscitation (CPR) was first introduced in 1960 for people who unexpectedly experience sudden cardiac arrest. Over the years, it became routine practice in all institutions to perform CPR for all patients even though, for some patients with fatal conditions, application of CPR only prolongs the dying process through temporarily restoring cardiac function.

Objectives: This analysis aims to systematically review the literature to provide an accurate estimate of survival following CPR in patients with terminal health conditions.

Data sources: A literature search was performed for studies published from January 1, 2004, until January 10, 2014. The search was updated monthly to March 1, 2014.

Review methods: Abstracts and full text of studies that met eligibility criteria were reviewed. Reference lists were also examined for any additional relevant studies not identified through the search.

Results: Cancer patients have lower survival rates following CPR than patients with conditions other than cancer, and cancer patients who receive CPR in intensive care units have one-fifth the rate of survival to discharge of cancer patients who receive CPR in general wards. While the meta-analysis of studies published between 1967 and 2005 reported a lower survival to discharge for cancer patients (6.2%), more recent studies reported higher survival to discharge or to 30-day survival for these patients. Higher survival rates in more recent studies could originate with more "do not attempt resuscitation" orders for patients with end-stage cancer in recent years. Older age does not significantly decrease the rate of survival following CPR while the degree, the type, and the number of chronic health conditions; functional dependence; and multiple CPRs (particularly in advanced age) do reduce survival rates. Emergency Medical Services response time have a significant impact on survival following out-of-hospital CPR.

Conclusions: Survival after CPR depends on the severity of illness, type and number of health conditions, functional dependence, and multiple CPRs.

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Figures

Figure 1:
Figure 1:. Citation Flow Chart
Figure 2:
Figure 2:. Survival Following In-Hospital Cardiopulmonary Resuscitation: Patients With Cancer Versus Without Cancer According to Age Categories
Figure 3:
Figure 3:. Survival to Discharge Following In-Hospital Cardiopulmonary Resuscitation for Patients with Cancer According to Type of Cancer
Figure 4:
Figure 4:. Survival Following In-Hospital Cardiopulmonary Resuscitation for Patients with Cancer According to Type of Cancer and Period
Figure 5:
Figure 5:. Survival to Discharge Following In-Hospital Cardiopulmonary Resuscitation for Patients with Cancer According to Location of Cardiac Arrest
Figure 6:
Figure 6:. Survival to Discharge Following In-Hospital Cardiopulmonary Resuscitation for Patients with Chronic Health Conditions According to Type of Chronic Health Condition
Figure 7:
Figure 7:. Survival to Discharge Following Out-of-Hospital Cardiopulmonary Resuscitation for Patients with Chronic Health Conditions According to the Number of Chronic Health Conditions
Figure 8:
Figure 8:. Survival Following In-Hospital Cardiopulmonary Resuscitation According to Age Categories: Reports From 2 Studies
Figure 9:
Figure 9:. Survival to Discharge Following In-Hospital Cardiopulmonary Resuscitation: Patients 65 Years and Older According to Age and Frequency of Cardiopulmonary Resuscitation
Figure 10:
Figure 10:. Survival to Discharge Following In-Hospital Cardiopulmonary Resuscitation for Patients 65 Years and Older According to Residential and Functional Status
See this image and copyright information in PMC

References

    1. Heyland DK, Frank C, Groll D, Pichora D, Dodek P, Rocker G, et al. Understanding cardiopulmonary resuscitation decision making: perspectives of seriously ill hospitalized patients and family members. Chest. 2006 Aug; 130(2): 419–28. - PubMed
    1. Adams DH, Snedden DP. How misconceptions among elderly patients regarding survival outcomes of inpatient cardiopulmonary resuscitation affect do-not-resuscitate orders. J Am Osteopath Assoc. 2006 Jul; 106(7): 402–4. - PubMed
    1. Ehlenbach WJ, Barnato AE, Curtis JR, Kreuter W, Koepsell TD, Deyo RA, et al. Epidemiologic study of in-hospital cardiopulmonary resuscitation in the elderly. N Engl J Med. 2009 Jul 2; 361(1): 22–31. - PMC - PubMed
    1. Ebell MH, Becker LA, Barry HC, Hagen M. Survival after in-hospital cardiopulmonary resuscitation. A meta-analysis. J Gen Intern Med. 1998 Dec; 13(12): 805–16. - PMC - PubMed
    1. Guyatt GH, Oxman AD, Schunemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol. 2011 Apr; 64(4): 380–2. - PubMed

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