New Study Highlights Decline in Survival Rate During CPR for Cardiac Arrest in Hospitals
A recent study published in The BMJ has shed light on the rapid decline in a person’s chance of survival during cardiopulmonary resuscitation (CPR) for cardiac arrest in hospitals. The findings of this study have important implications for hospital teams, patients, and their families when determining how long to continue resuscitation efforts.
The study, which analyzed data from 348,996 US adults who experienced in-hospital cardiac arrest between 2000 and 2021, found that the chance of survival decreases from 22% after one minute of CPR to less than 1% after 39 minutes. Similarly, the likelihood of leaving the hospital with no major brain damage decreases from 15% after one minute to less than 1% after 32 minutes with no heartbeat.
In-hospital cardiac arrest is a common and serious medical emergency, with only around 25% of patients surviving to hospital discharge. Previous studies have shown that longer resuscitation times are associated with lower odds of survival. However, specific recommendations on when to stop resuscitation have been lacking until now.
The researchers suggest that these findings can provide valuable insights for hospital teams, patients, and their families in determining how long to continue resuscitation efforts. While it is important to note that these findings are observational and the researchers had to make assumptions about terminating resuscitation, the study is considered well-designed and used the largest in-hospital cardiac arrest dataset in the world. Thus, the findings are applicable to hospitals seeking to improve their resuscitation performance.
According to the study, 67% of patients achieved a return of spontaneous circulation with an average CPR duration of 7 minutes, while 33% did not achieve a return of spontaneous circulation with an average CPR duration of 20 minutes. The probabilities of survival and favorable functional outcome were 22% and 15%, respectively, at one minute of CPR duration. However, as the duration of CPR increased, the probabilities of survival and favorable functional outcome decreased to less than 1% at 39 minutes and 32 minutes, respectively.
The researchers believe that these findings can help inform resuscitation teams, patients, and their surrogates about the likelihood of favorable outcomes when deciding whether to continue CPR after the first return of spontaneous circulation. By having this information, healthcare professionals can make more informed decisions and potentially improve patient outcomes in cases of in-hospital cardiac arrest.
