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Functional Status Among Survivors of In-Hospital Cardiopulmonary Resuscitation
John D. FitzGerald, MD, MPH;
Neil S. Wenger, MD, MPH;
Robert M. Califf, MD;
Russell S. Phillips, MD;
Norman A. Desbiens, MD;
Honghu Liu, PhD;
Joanne Lynn, MD, MA;
Albert W. Wu, MD, MPH;
Alfred F. Connors, Jr, MD;
Robert K. Oye, MD
Arch Intern Med. 1997;157(1):72-76.
Abstract
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Objectives
To describe functional outcomes of seriously ill patients who survived 2 months after inhospital cardiopulmonary resuscitation (CPR) and to identify patient and clinical characteristics associated with worse functional status after CPR.
Methods
Multicenter prospective observational analysis of 162 seriously ill hospitalized patients who survived 2 months after CPR. Analysis of clinical characteristics associated with worse functional outcome.
Results
Among 162 survivors of in-hospital CPR, 56% had the same or improved function and 44% had worse function at 2 months compared with functional status before CPR. Patients with worse function deteriorated by a mean of 3.9 activities of daily living and were less likely to survive to hospital discharge (P<.001) or to 6 months after study entry (P<.001). Worse functional outcome was associated with greater age and longer hospital stay before CPR.
Conclusions
More than half of CPR survivors had preserved functional status 2 months after CPR. However, patients with worse function are profoundly disabled. In anticipation of possible severe disability after CPR, preferences for care in such health states should be discussed with patients before the need for CPR, particularly among older patients and those with long hospital stays.
Arch Intern Med. 1996;156:72-76
Author Affiliations
From the UCLA School of Medicine, Los Angeles, Calif (Drs FitzGerald, Wenger, Liu, and Oye); Duke University Medical Center, Durham, NC (Dr Califf); Beth Israel Hospital, Boston, Mass (Dr Phillips); Marshfield Medical Research Foundation, Marshfield, Wis (Dr Desbiens); Center to Improve Care of the Dying, George Washington University, Washington, DC (Dr Lynn); Johns Hopkins School of Public Health, Baltimore, Md (Dr Wu); and MetroHealth Medical Center, Cleveland, Ohio (Dr Connors).
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