Outcomes of In–Hospital Cardiopulmonary Resuscitation in Patients with CKD

Saeed, Fahad; Adil, Malik M; Kaleem, Umar; Zafar, Taqi T; Khan, Abdus Salam; Holley, Jean Lake; Nally, Joseph V.

doi:10.2215/cjn.07530715

Cited by 10 publications

(10 citation statements)

References 22 publications

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“…We included all patients ≥ 18 years of age with an International Classification of Diseases, 9th Revision, Clinical Modification (ICD‐9‐CM) primary or secondary procedure code for in‐hospital CPR (99.60, 99.63) to identify the main cohort of adult patients who received in‐hospital CPR during the years 2006‐2014. These codes have been used in previous studies using administrative databases to identify patients receiving in‐hospital CPR . We excluded patients with cardiopulmonary arrest (427.50) as a primary diagnosis in our analysis as this may represent patients who had experienced an out‐of‐hospital arrest …”

Section: Methodsmentioning

confidence: 99%

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Outcomes of in‐hospital cardiopulmonary resuscitation for patients with end‐stage liver disease

Ufere

Brahmania

Sey

et al. 2019

Liver International

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Background and Aims:There have been improving survival trends after in-hospital cardiac arrest for the general population, but there is limited information on the outcomes of hospitalized patients with end-stage liver disease (ESLD) who undergo cardiopulmonary resuscitation (CPR). We aimed to examine survival to hospital discharge after receipt of in-hospital CPR in patients with ESLD using a nationally representative sample. Methods:We used the Nationwide Inpatient Sample database from 2006 to 2014 to identify adult patients who underwent in-hospital CPR. Using multivariate modelling, we compared survival to hospital discharge for patients with ESLD to those without ESLD. We also compared outcomes of patients with ESLD to patients with metastatic cancer.Results: A total of 177 533 patients underwent in-hospital CPR, of which 1474 (0.8%) had ESLD. Patients with ESLD had lower rates of survival to hospital discharge compared to patients without ESLD (10.7% vs 28.6%, P < 0.01). In multivariate modelling, ESLD was significantly associated with lower odds of survival to hospital discharge after in-hospital CPR (OR 0.35, 95% CI 0.28-0.44, P < 0.01). Among survivors of inhospital CPR, ESLD patients had a significantly lower chance of discharge to home compared to patients without ESLD (3.2% vs 8.0%, P < 0.05). Patients with ESLD also had lower rates of survival to hospital discharge compared to those with metastatic cancer (10.7% vs 15.5%, P < 0.01). Conclusions:Outcomes are poor after in-hospital CPR in patients with ESLD and are worse than for patients with metastatic cancer. The current analysis can be used to inform goals of care discussions for patients with ESLD. K E Y W O R D S cardiac arrest, code status, decompensated cirrhosis, goals of care | 1257 UFERE Et al. S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: Ufere NN, Brahmania M, Sey M, et al. Outcomes of in-hospital cardiopulmonary resuscitation for patients with end-stage liver disease. Liver Int.

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Section: Methodsmentioning

confidence: 99%

“…These codes have been used in previous studies using administrative databases to identify patients receiving in‐hospital CPR . We excluded patients with cardiopulmonary arrest (427.50) as a primary diagnosis in our analysis as this may represent patients who had experienced an out‐of‐hospital arrest …”

Section: Methodsmentioning

confidence: 99%

Outcomes of in‐hospital cardiopulmonary resuscitation for patients with end‐stage liver disease

Ufere

Brahmania

Sey

et al. 2019

Liver International

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“…Lastly, we recognize that although CPR knowledge questions were derived from similar surveys and publicly available information regarding CPR facts and outcomes in the CKD population, the questionnaire had not been validated and newer data regarding survival post-CPR for CKD patients has since been published. 2 Despite these limitations, we believe our data reliably demonstrate key differences in understanding of CPR between Black and White CKD patients and the mediating effect of health literacy in this relationship.…”

Section: Discussionmentioning

confidence: 66%

“…30 Patients with CKD have high rates of limited health literacy and experience frequent complications and poor survival during hospitalizations when they receive CPR. 2, 35 Therefore, it is imperative that providers delineate the risks of this therapy and confirm understanding with patients and their loved ones during advance care planning discussions. To our knowledge, there have not been any studies that have investigated the impact of health literacy-sensitive interventions to improve EOL treatment knowledge within nephrology.…”

Section: Discussionmentioning

confidence: 99%

Health Literacy Mediates Racial Disparities in Cardiopulmonary Resuscitation Knowledge among Chronic Kidney Disease Patients

Eneanya¹,

Olaniran²,

Xu³

et al. 2018

Journal of Health Care for the Poor and Underserved

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Black patients with chronic kidney disease (CKD) receive more cardiopulmonary resuscitation (CPR) than other racial groups, and knowledge of CPR influences preferences for care. As limited health literacy disproportionately affects Blacks and contributes to disparities in end-of-life (EOL) care, we investigated whether health literacy mediates racial disparities in CPR knowledge. Black and White adult patients with advanced CKD completed CPR knowledge surveys. Health literacy was assessed using the Rapid Estimate of Adult Literacy in Medicine. Among 149 patients, Black patients were more likely to have limited health literacy and lower mean CPR knowledge scores than White patients. In adjusted analyses, health literacy mediated racial differences in CPR knowledge. Knowledge of CPR is lower among Black compared with White CKD patients and health literacy is a mediator of this difference. Future CPR educational interventions should target health literacy barriers to improve informed decision-making and decrease racial disparities at the end-of-life.

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“…1 Moreover, patients on HD have increased mortality with CA in comparison with the general population. 2 Finally, for those patients who survive, there may be a higher rate of discharge to nursing homes and lower functional status. 3 Improving outcomes after CA requires a multipronged approach, including education to provide timely cardiopulmonary resuscitation (CPR) and defibrillation when appropriate and secondary preventative strategies for survivors.…”

mentioning

confidence: 99%

Cardiopulmonary Resuscitation in Outpatient Dialysis Clinics: Perception of Futility?

Imbeault

Chan

2019

JASN

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Outcomes of In–Hospital Cardiopulmonary Resuscitation in Patients with CKD

Abstract: In conclusion, we observed slightly higher in-hospital mortality in patients with CKD undergoing in-hospital cardiopulmonary resuscitation.

Cited by 10 publications

References 22 publications

Outcomes of in‐hospital cardiopulmonary resuscitation for patients with end‐stage liver disease

Outcomes of in‐hospital cardiopulmonary resuscitation for patients with end‐stage liver disease

Health Literacy Mediates Racial Disparities in Cardiopulmonary Resuscitation Knowledge among Chronic Kidney Disease Patients

Cardiopulmonary Resuscitation in Outpatient Dialysis Clinics: Perception of Futility?

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