Factors Associated with Survival and Eventual Cerebral Status Following Cardiac Arrest

Sowden, G. R.; Robins, D. W.; Baskett, Peter; Otto, Charles W.

doi:10.1097/00132586-198504000-00038

Cited by 2 publications

(3 citation statements)

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“…For example, Bedell et al initially found a strong relation between the diagnosis and failure to survive to discharge after CPR, 12 although others have not always duplicated this finding. 15,21,40,55 In the current metaanalysis, pneumonia was not significantly associated with either immediate survival or survival to discharge. Certainly, differences in the criteria for diagnosis may affect these results.…”

Section: Predictors Of Survival To Dischargecontrasting

confidence: 50%

“…The subset of 10 studies meeting the strict inclusion criteria included 2,434 patients. Among the 41 studies that met the minimal criteria, 12 took place in Europe, 13,15,17,19,28,31,38,[40][41][42][43][44]48 one each in Australia, 22 Israel, 24 and Japan, 30 12 (1983) 294 All adults Y x x x Gulati et al 13 (1983) 52 Adults Ն age 64 N x Scaff et al 14 (1984) 242 All adults N x x Sowden et al 15 (1984) 108 All adults N x ? ?…”

Section: Discussionmentioning

confidence: 99%

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Survival after in-hospital cardiopulmonary resuscitation

et al. 1998

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OBJECTIVE:To determine the rates of immediate survival and survival to discharge for adult patients undergoing in-hospital cardiopulmonary resuscitation, and to identify demographic and clinical variables associated with these outcomes. MEASUREMENTS AND MAIN RESULTS:The MEDLARS database of the National Library of Medicine was searched. In addition, the authors' extensive personal files and the bibliography of each identified study were searched for further studies. Two sets of inclusion criteria were used, minimal (any study of adults undergoing in-hospital cardiopulmonary resuscitation) and strict (included only patients from general ward and intensive care units, and adequately defined cardiopulmonary arrest and resuscitation). Each study was independently reviewed and abstracted in a nonblinded fashion by two reviewers. The data abstracted were compared, and any discrepancies were resolved by consensus discussion. For the subset of studies meeting the strict criteria, the overall rate of immediate survival was 40.7% and the rate of survival to discharge was 13.4%. The following variables were associated with failure to survive to discharge: sepsis on the day prior to resuscitation (odds ratio T he do-not-resuscitate (DNR) order has become well accepted and widely used in American hospitals, and for the majority of patients who die in the hospital, a DNR order has been written by the time of their death. 1-3 The decision to discuss or execute a DNR order is driven by several concerns: the patient's current quality of life, the likelihood that cardiopulmonary resuscitation (CPR) will be successful, the patient's long-term prognosis following successful resuscitation, and his or her anticipated quality of life following successful resuscitation. 4,5 Although judgments about quality of life are best assessed by the patient, physicians have typically been relied on to provide biomedical information and estimates of prognosis; this is consistent with a shared approach to medical decision making. Information about prognosis can either be communicated implicitly (e.g., "I don't think CPR is likely to help you") or explicitly ("Patients with your condition have a less than 1% chance of surviving to discharge after CPR"). The explicit approach has been shown in two studies to influence patient decisions about DNR orders, 6,7 so it is important that prognostic information be as accurate as possible.[Recent work has shown, however, that physicians are not accurate in predicting the outcome of CPR. In fact, when presented with detailed vignettes of actual patient cases, physician predictions of the likelihood of immediate survival following CPR were no better than random guessing, with an area under the receiver-operating characteristic (ROC) curve not significantly different from 0.5. 8 An analysis with the physician prediction of the likelihood of survival as the outcome variable in a multivariate regression shows that physicians appear to have an underlying cognitive model. However, this model overemphasizes the imp...

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Section: Predictors Of Survival To Dischargecontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Survival after in-hospital cardiopulmonary resuscitation

et al. 1998

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“…Unfortunately, current decision aids have failed to predict survival. 9 In agreement with the literature, [9][10][11][12][13][14][15][16][17][18] these decision aids consider the age of the patient, the level of self-care, and the presence or absence of morbidity before CPR. The fact that morbidities occur over time is not considered.…”

mentioning

confidence: 55%

In-hospital Cardiopulmonary Resuscitation

Vos¹,

Koster²,

Haan³

et al. 1999

Arch Intern Med

110

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Time of prearrest morbidity has a prognostic value for survival after CPR. Patients at risk for poor survival can be identified on or during hospital admission, but the reliability and validity of the model needs further research. Although decisions will not be made by the model, its information can be useful for physicians in discussions about patient prognoses and to make decisions about CPR with more confidence.

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Factors Associated with Survival and Eventual Cerebral Status Following Cardiac Arrest

Cited by 2 publications

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Survival after in-hospital cardiopulmonary resuscitation

Survival after in-hospital cardiopulmonary resuscitation

In-hospital Cardiopulmonary Resuscitation

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