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Thomas W. Zoch, MD; Norman A. Desbiens, MD; Frank DeStefano, MD; Dean T. Stueland, MD; Peter M. Layde, MD

Arch Intern Med. 2000;160:1969-1973.

Background  The objective was to evaluate the effect of patient characteristics and other factors on cardiopulmonary resuscitation (CPR) survival, hospital discharge survival and function, and long-term survival.

Methods  All patients 18 years and older experiencing in-hospital CPR from December 1983 through November 1991 at Marshfield Medical Center (Marshfield Clinic and adjoining St Joseph's Hospital), Marshfield, Wis, were selected. We performed a retrospective medical record review and augmented these data with updated vital status information.

Main Outcome Measures  Cardiopulmonary resuscitation survival, hospital discharge survival and function, and long-term survival.

Results  Of 948 admissions during which CPR was performed, 61.2% of patients survived the arrest and 32.2% survived to hospital discharge. Mechanism of arrest was the most important variable associated with hospital discharge. Patients with pulseless electrical activity had the worst chance of hospital discharge, followed by those with asystole and bradycardia. Follow-up information was available for 298 patients who survived to discharge. One year after hospital discharge, 24.5% of patients, regardless of age, had died. Survival was 18.5% at 7 years in those 70 years or older, compared with 45.4% in those aged 18 to 69 years. Heart rhythm at the time of arrest strongly influenced long-term survival. Bradyarrhythmias produced a nearly 2-fold increased mortality risk compared with normal sinus rhythm.

Conclusions  Survival until hospital discharge after CPR at our institution during an 8-year period was higher than previously reported for other institutions. Long-term survival after discharge was equal to or higher than reported estimates from other institutions. Hospital admission practices and selection of patients receiving CPR may account for these findings.

From Theda Clark Regional Medical Center, Neenah, Wis (Dr Zoch); Marshfield Clinic, Marshfield, Wis (Drs Zoch, Desbiens, and Stueland); Chattanooga Unit, University of Tennessee College of Medicine, Chattanooga (Dr Desbiens); Centers for Disease Control and Prevention, Atlanta, Ga (Dr DeStefano); Marshfield Medical Research and Education Foundation, Marshfield (Drs DeStefano and Layde); and Medical College of Wisconsin, Milwaukee (Dr Layde).
Dr Stueland is deceased.

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