The Outcomes Of Cardiopulmonary Resuscitation In Emergency Department And Its Influencing Factors

Objective To study the outcomes of cardiopulmonary resuscitation (CPR) in emergency department and the various factors that may affect the outcomes of CPR. Methods A retrospective analysis from January 1,2008 to June 30,2012 was done, including all the cardiac arrest patients treated in the emergency department of Peking Union Medical College Hospital. All the factors which may affect the outcomes of CPR were recorded, such as the gender, age, self-care ability of daily life before cardiac arrest, the cause of cardiac arrest, cardiac arrest occurring area, initial rhythm, accumulated dosages of epinephrine, the duration of CPR, whether there have been respiratory support or circulatory support before cardiac arrest, and if the cardiac arrest happened out of the hospital, whether there was a bystander CPR. We defined CPR outcomes as three main points, the return of spontaneous circulation, survived to discharge and survived to discharge with favorable neurologic function. SPSS 17.0 was performed to analysis these data to find out the relationships between the influencing factors and the outcomes of CPR. Results During the study period, there were a total of 1936 patients who had a cardiac arrest, and 597 of them were included in the study.219 cases (36.7%) had return of spontaneous circulation, but only 19 cases(3.2%) survived,16 cases (2.7%) had favorable neurological survival. Gender, age, cardiac arrest occurring area, self-care ability of daily life, respiratory or circulatory support or not before arrest, bystander CPR for out-of-hospital cardiac arrest, all of which were not associated with CPR outcomes, and the cause of cardiac arrest, initial rhythm, accumulated dosages of epinephrine and CPR duration affected the outcomes of CPR. Conclusions It is better to reflect the prognosis of CPR when classify the cause with treatable origin or non-treatable origin in short term than with cardiac origin or non-cardiac origin. Treatable cause in short term, a shockable rhythm, accumulated dosages of epinephrine not more than 5mg and the CPR duration less than 15 minutes are favorable factors with good neurological function discharged home.