Outcomes of In-Hospital Cardiopulmonary Resuscitation in Patients with Chronic Kidney Disease (SA527D)

Abstract

•Learn about the outcomes of cardiopulmonary resuscitation (CPR) in chronic kidney disease (CKD) patients.•Learn about the outcomes of CPR in CKD patients who are ≥75 years of age. Advance care planning including code status discussion is an essential part of the medical care of patients with chronic kidney disease (CKD). There is little information on the outcomes of cardiopulmonary resuscitation (CPR) in these patients. We aimed to compare the following CPR-related outcomes in CKD patients with the general population by using Nationwide Inpatient Sample (NIS): (1) survival to hospital discharge; (2) discharge destination; and, (3) length of hospital stay. We analyzed data from Nationwide Inpatient Sample (NIS 2005- 2011), including patients with and without CKD who had undergone in-hospital CPR. Baseline characteristics, in-hospital complications, and discharge outcomes were compared between the two groups. Chi-square for categorical and t-test for continuous variables were used in the univariate analysis to build logic regression analyses models to analyze CPR-related outcomes. 71,961 CKD patients underwent in-hospital CPR compared to 323,620 patients from the general population. Unadjusted in-hospital mortality rates were higher in CKD patients (72 % versus. 75%, p=<.0001) on univariate analysis. After adjusting for age, gender, and potential confounders, CKD patients had higher odds of mortality: odds ratio 1.24, 95 % CI 1.11-1.3, p=<.0001. Hospitalization charges and length of stay were also greater in CKD patients. There was no overall difference in post-CPR nursing home placement between the two groups. In a separate sub-analysis of CKD patients ≥75 years, higher odds of in-hospital mortality {1.30(1.20-1.42), P <.0001} and likelihood of nursing home discharge {1.60(1.36-1.89) <.0001} were noted. CKD patients have poor survival after CPR compared to the general population. Mortality is even higher in CKD patients who are ≥75 years of age.