A Prospective Study of Survival After In-Hospital Cardiopulmonary Resuscitation and its Related Factors

Background: Despite several studies, there is no agreement on factors that affect survival after in-hospital cardiopulmonary resuscitation (CPR). Objectives: This study aimed to evaluate the survival rate of in-hospital CPR and its related factors at Shahid Beheshti hospital in Kashan, Iran, in ۲۰۱۴. Patients and Methods: A descriptive study was conducted on all cases of CPR performed in Kashan Shahid Beheshti hospital during a ۶-month period in ۲۰۱۴. Through a consecutive sampling method, ۲۵۰ cases of CPR were studied. A three-part researcher-made instrument was used. The outcome of CPR was documented as either survival to hospital discharge or unsuccessful (death of the patient). Chi-square test, t test, and logistic regression analysis were used to analyze the data. Results: Of all CPR cases, ۲۳۸ (۹۵.۲%) were unsuccessful and ۱۲ (۴.۸%) survived to hospital discharge. Only ۲.۶% of patients who were resuscitated in medical units survived to hospital discharge, whereas this rate was ۱۱.۴% in the emergency department. Only ۴۵ (۱۸%) patients were defibrillated during resuscitation; in ۱۱ patients, defibrillation was performed between ۱۵ to ۴۵ minutes after the initiation of CPR. The mean time from initiation of CPR to the first DC shock was ۱۳.۹۳ ± ۸.۸۸ minutes. Moreover, the mean duration of CPR was ۳۵.۱۱ ± ۱۱.۴۲ minutes. The survival rate was higher in the morning shift and lower during the time of shift change (۹.۴% vs. ۰). The duration of CPR and speed of arrival of the CPR team were identified as factors that predicted the outcome of CPR. Conclusions: The survival rate after in-hospital CPR was very low. The duration of CPR and the time of initiating CPR effects patients’ outcomes. These findings highlight the crucial role of an organized, skilled, well-established and timely CPR team.