• Critical care medicine · Oct 1999

    Comparative Study

    Resuscitation in the hospital: differential relationships between age and survival across rhythms.

    • D C Parish, F C Dane, M Montgomery, L J Wynn, and M D Durham.
    • Department of Internal Medicine, Medical Center of Central Georgia and Mercer University School of Medicine, Macon, USA.
    • Crit. Care Med. 1999 Oct 1; 27 (10): 2137-41.

    ObjectiveAssess the frequency and outcome of inhospital resuscitation and determine the relationship between patient age and survival and whether it is affected by initial rhythm.DesignRetrospective, single-institution, registry study of inhospital resuscitation.SettingA 550-bed, tertiary-care, teaching hospital in Macon, GA.PatientsAll admissions for which a resuscitation was attempted in the Medical Center of Central Georgia during the period of January 1, 1987 through December 31, 1993. The registry sample included 2,394 admissions, for which 2,813 resuscitation attempts were made; only the first resuscitation attempt during an admission was analyzed.InterventionsNone.Measurements And Main ResultsRates of survival to discharge steadily increased from 24.4% in 1987 to 38.6% in 1993; the overall survival rate was 26.8%. Age, used as a continuous variable, was strongly related to survival (odds ratio = 0.984; p < .0001). Categorically, overall survival rates for pediatric, adult, and geriatric patients were 56.4%, 29.0%, and 24.0%, respectively. Survival rates also varied significantly (odds ratio = 0.469; p < .0001) among initial rhythms, i.e., supraventricular tachycardia (60.7%), ventricular tachycardia (57.6%), perfusing rhythms (49.84%), ventricular fibrillation (32.0%), pulseless electrical activity (14.6%), and asystole (9.1%). The relationship between age and survival did not change across the years included in the study, but did vary as a function of initial rhythm (p < .0001). Age was positively related to survival when initial rhythm was supraventricular tachycardia (p = .04), negatively related to survival when the initial rhythm was perfusing (p < .0001) or pulseless electrical activity (p = .0002), and not related to survival when the initial rhythm was ventricular tachycardia (p = .98), ventricular fibrillation (p = .14), or asystole (p = .21).ConclusionsThe relationship between patient age and a successful resuscitation attempt is not as simple as reported earlier. Whether age is related to increased or decreased survival, or is unrelated to survival, depends on the rhythm extant when resuscitation attempts begin. Survival rates were higher than most reported elsewhere and improved significantly over time. Multicentered studies are needed to determine whether these results are unique to the institution studied.

      Pubmed     Full text   Copy Citation  

      Add institutional full text...

    Notes

    hide…