Abstract W P315: Outcomes Of In-hospital Cardiopulmonary Resuscitation In Stroke Patients Admitted In The United States, Years 2005-2011

Abstract

Background: There is no recent study on the outcomes of cardiopulmonary resuscitation (CPR) in stroke patients. We wanted to analyze the outcomes of in-hospital CPR in these patients in comparison with the general population without stroke. Methods: Data from all patients admitted to US hospitals between 2005 and 2011 were analyzed. We used the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) primary or secondary procedure codes 99.60 to identify the adult patients (≥18years) who underwent cardiopulmonary resuscitation. Patients who had cardiopulmonary arrest (427.50) as a primary admission diagnosis were excluded to avoid including patients who experienced an out-of hospital event in our analysis. The effect of stroke on discharge outcomes was analyzed after adjusting for potential confounders using logistic regression analysis. Yearly national trends in survival in stroke patients were examined using the Cochran-Armitage trend test. Results: Of 648,168 patients who underwent CPR, 43753 (6.8%) were admitted withstroke. Strokeatients who underwent CPR had higher rates of discharge to nursing facility (18.4% versus 14.0% p=<0.0001) but no difference was noted in in-hospital mortality (74.1% versus 74.2% p= 0.9) compared to those without stroke. After adjusting for potential confounders, CPR in patients with stroke had higher odds of discharge to nursing facility [odds ratio (OR) 1.8, 95% confidence interval (CI) (1.6-2.0, p= <.0001)] and death [(OR) 1.11, 95% (CI) (1.06-1.14, p=0.05)]. Survival in stroke patients undergoing CPR improved in 2011 (19 % in the year 2011 vs. 11 % in the year 2005; p=<.0001) as compared with the previous years. Conclusion: CPR in stroke patients is associated with significantly higher rates of disability at discharge. Survival appears to be improving over the last 6 years in these patients.