Prolonged Cardiopulmonary Resuscitation Process and Lower Frequency of Medical Staff Visit Predicts Independently In-hospital Resuscitation Success in the Elderly Population

Abstract

Cardiopulmonary resuscitation during hospitalization has a great impact on both economic and medical issues. We sought to investigate: (1) whether different nursing-care behavior would alter the in-hospital resuscitation success rate; and (2) whether the success rate was influenced further by different age groups. From January to December 2007, a total of 983 cases underwent cardiopulmonary resuscitation (CPR) in a tertiary medical center. Of these, the 170 cases resuscitated on the general wards were included in our study, but the 543 events that occurred in the emergency department and the 270 events that occurred in the intensive care units were excluded. Cases were further divided into two groups based on age (O for age greater than or equal to 65 years; Y for age less than 65 years). The baseline hospitalization information and nursing factors in the prediction of immediate outcome after CPR in different age populations were tested by multivariate logistic regression. Of the 983 cases, 170 had detailed records prior to CPR. There was a significant relationship in the success rate of initial resuscitation after CPR between the elderly and young population ( p = 0.047). After multivariate adjustments for: signed as “do not resuscitate”; the type of rhythm acquired during resuscitation; the duration of staff visit; and the duration of CPR, we found that a prolonged CPR process was associated with a higher mortality rate in both groups (adjusted OR : 0.241, p = 0.001 in the O group vs. 0.220, p = 0.001 in the Y group). A longer interval between medical staffs’ visits before CPR was associated with higher mortality in the O group (adjusted OR : –0.048, p = 0.015) as compared with the Y group. Although the initial resuscitation success rate was not affected by age, a longer time interval between the last medical staffs’ visit and the onset of resuscitation did result in a worse success rate in elderly patients. Our data suggest that more frequent staff visits to the elderly population during hospitalization could alter initial resuscitation results.