• Steven M Bradley, Wenhui Liu, Paul S Chan, Saket Girotra, Zachary D Goldberger, Javier A Valle, Sarah M Perman, Brahmajee K Nallamothu, and American Heart Association’s Get With the Guidelines-Resuscitation Investigators.
• Minneapolis Heart Institute, Minneapolis, MN, United States(1). Electronic address: Steven.Bradley@allina.com.
• Resuscitation. 2017 Apr 1; 113: 128-134.

BackgroundThe duration of resuscitation efforts has implications for patient survival of in-hospital cardiac arrest (IHCA). It is unknown if patients with better predicted survival of IHCA receive longer attempts at resuscitation.MethodsIn a multicenter observational cohort of 40,563 adult non-survivors of resuscitation efforts for IHCA between 2000 and 2012, we determined the pre-arrest predicted probability of survival to discharge with good neurologic status, categorized into very low (<1%), low (1-3%), average (>3%-15%), and above average (>15%). We then determined the association between predicted arrest survival probability and the duration of resuscitation efforts.ResultsThe median duration of resuscitation efforts among all non-survivors was 19min (interquartile range 13-28min). Overall, the median duration of resuscitation efforts was longer in non-survivors with a higher predicted probability of survival with good neurologic status (median of 16, 17, 20, and 23min among the groups predicted to have very low, low, average, and above probabilities, respectively; P<0.001). However, the duration of resuscitation was often discordant with predicted survival, including longer than median duration of resuscitation efforts in 40.4% of patients with very low predicted survival and shorter than median duration of resuscitation efforts in 31.9% of patients with above average predicted survival.ConclusionsThe duration of resuscitation efforts in patients with IHCA was generally consistent with their predicted survival. However, nearly a third of patients with above average predicted outcomes received shorter than average (less than 19min) duration of resuscitation efforts.Published by Elsevier B.V.

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