Patients who are resuscitated after a cardiopulmonary arrest in the hospital often have a high mortality rate. Certain factors can separate those with a better prognosis from those with a worse.
General population findings:
(1) Vital signs are restored in 40-50% of those resuscitated.
(2) Mortality of those having a cardiopulmonary arrest is 85-95%, with only 5-15% discharged alive.
(3) Of those discharged alive, 25% may die in the next 6 months.
Certain findings present before, during or after the resuscitation were found to be associated with mortality in the hospital following the resuscitation.
|
Period Relative to Arrest |
Significant Condition |
Estimated Coefficient |
|
before arrest |
hypotension (systolic blood pressure < 100 mm Hg) |
2.69 |
|
|
pneumonia |
2.85 |
|
|
renal failure (BUN > 50 mg/dL) |
2.75 |
|
|
cancer |
1.06 |
|
|
homebound life style |
2.13 |
|
during arrest |
arrest duration > 15 minutes |
2.51 |
|
|
intubation required |
2.35 |
|
|
hypotension (systolic blood pressure < 100 mm Hg) |
2.70 |
|
|
pneumonia |
2.48 |
|
|
homebound life style |
2.24 |
|
after resuscitation |
coma |
2.40 |
|
|
need for pressors |
2.16 |
|
|
arrest duration > 15 minutes |
1.87 |
Additional factors with poor prognosis:
(1) sepsis
(2) multi-organ failure prior to arrest
(3) advanced age with limited physiologic reserve
(4) chronic disease with limited physiologic reserve
(5) acute stroke accompanied by neurologic deficit
|
Condition |
Mortality Rate |
|
homebound lifestyle prior to arrest |
95% |
|
advanced age with limited physiologic reserve |
>= 95% |
|
chronic disease with limited physiologic reserve |
>= 95% |
|
acute stroke accompanied by neurologic deficit |
>= 95% |
|
cancer |
95% |
|
pneumonia |
95% |
|
sepsis |
>= 95% |
|
multi-organ failure prior to arrest |
>= 95% |
|
hypotension |
95% |
|
renal failure |
95% |
|
require intubation |
91% |
|
not intubated |
55% |
|
resuscitation <= 15 minutes |
44% |
|
resuscitation > 15 minutes |
82,91,95% |
|
resuscitation > 30 minutes |
100% |
|
coma 24 hours after resuscitation |
>= 95% |
|
resuscitation <= 15 minutes, no pressors required, alert |
8% |
|
alive 24 hours after resuscitation |
58% |
|
negative for a history of hypotension, renal failure, pneumonia, cancer and homebound lifestyle |
34% |
Limitations:
• Sometimes the mortality rates given seem contradictory. For example the mortality rate given when the resuscitation takes more than 15 minutes ranges from 82 to 91 to 95%. Some of the patients had several risk factors, which would affect the rates when only one was being examined.
Specialty: Cardiology
ICD-10: ,
