The Filipino Cardiopulmonary Resuscitation Outcomes Study (Filipino CPR 2015) Among Adult Cardiac Arrest Patients in Tertiary Hospitals in the Philippines: A Prospective Study

Jerelyn Adviento,Orlando Bugarin,Ma Kristine Joy S Calvario,Alex Junia,Francis Lavapie,Maria Luz Joanna Soria,Regidor Encabo,Vinhcent Sandoval,Rochelle Cruz,Alvin Dela Cruz,Ivan Valdez,Kathleen Cala,Arnee Anico-Tondo,Banisadar Mukaram,Cecile Jaca,Md; Aileen Lomarda Catapang,Neil Salces,Ciara Lesaca,Gina Ogaco,Nina Noreen Diansuy,Joseph Marc Seguban,Marylis E Javier,Nelson Acorda,Sharon Dispo,Lotlot Awil,Albert Hans Bautista,Ma Magdalena Avelino,Jeannica Kriselle Lerios,Nestor Lino Bagsit,Don Robespierre Reyes,Franco Onswald C Rubrica,Walid A Amil,Abdeltazer Mohammad

doi:10.69944/pjc.1632410c33

Abstract

Cardiopulmonary resuscitation (CPR) saves lives, but proper techniques must be taught and practiced. Outcomes have to be assessed to improve patient survival. Methods: This is an observational, analytical, prospective study of CPR in adult cardiac arrest cases from selected tertiary hospitals in the Philippines. It describes the characteristics and clinical factors associated with CPR survival in the Philippines based on the American Heart Association 2010 guidelines. Validated Philippine Heart Association hospital cardiac arrest collection forms were used to gather data on the demographics, pre-arrest and CPR/code characteristics of the cases. The investigators analyzed survival outcomes from first arrest to initial return of spontaneous circulation (ROSC) to hospital discharge. Epi Info 6 and STATA 11 statistical software were used for descriptive and inferential statistics, while the chi-square test was used for the association of variables (significant P-value set at <0.05). Stratified analysis and logistic regression analysis were done for confounders. Odds ratios (OR), 95% CI, and p-values were reported. Results: Out of 156 patients, 101 (65%) survived up to ROSC and hospital discharge. The investigators found significant differences in patient survival under the following factors: CPR medications (OR=16.729; 95% CI 1.979, 141.375; P=0.0097); and post-arrest therapeutic hypothermia (OR=8.745; CI 1.826, 41.882; P=0.0067). There were some decision errors on the use of defibrillation for shockable rhythms (26%) and non-shockable rhythms (14.5%). Eighteen rhythms were not properly identified. Conclusion: Decreased interval time from arrest to intubation and from arrest to call for code, CPR medications, and post-arrest therapeutic hypothermia were the most significant contributors to CPR survival in this study. Future training should address the errors in cardiac rhythm interpretation and defibrillator use. Keywords: CPR, ROSC, defibrillation, hypothermia, survival

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