Cardiopulmonary resuscitation: analysis of six years' experience and review of the literature

Abstract

A six-year series encompassing 1,073 cases of cardiopulmonary resuscitation (CPR) at St. Elizabeth Medical Center (SEMC) was analyzed and compared with 13,266 hospital CPR cases in the literature. SEMC had a CPR success rate of 56% and a survival-to-discharge rate of 24%, compared with 39% and 17%, respectively, in the literature. Compared with the anticipated death rate had these patients not undergone CPR, a hospital mortality reduction of over 6% was achieved. Resuscitation was attempted in about 30% of all deaths and in 1% to 1.5% of all admissions. Four or more resuscitation attempts on a patient during a single admission were uniformly associated with fatal outcome. The average age of CPR patients and survivors was 60 years. Half the primary causes were cardiac; one-fourth were pulmonary. CPR success was unaffected by patient location, but most patients initially arrested in the emergency department, which had the best survival to discharge rate. Of CPR patients who were discharged alive, 75% survived for at least one year. Fifty percent were alive after three years, and 20%, after five.