Resuscitation predictor scoring scale for inhospital cardiac arrests

Abstract

Objectives: The purpose of this study was to determine the key factors influencing survival from cardiopulmonary resuscitation attempts and to produce a survival predictor scale for use during a resuscitation attempt. Method: Bivariate analysis of individual survival predictors and a prospective analysis of survival based on logistic regression models. Included in this seven year study (1993-2000) were 2567 inhospital resuscitation calls of which 1633 received full cardiopulmonary resuscitation. Immediate, 24 hour and discharge survival rates were the main outcome measures with additional analysis for the development of the Resuscitation Predictor Scoring Scale (RPS Scale). Results: The immediate survival rate was 41%, 28% at 24 hours, and 19% by discharge. Multivariate analysis showed the main factors influencing 24 hour survival to be the duration of the arrest, primary arrhythmia (VT, VF, asystole, or PEA), age, and the primary mode of arrest (respiratory or cardiac). The RPS Scale was developed from these key predictors giving resuscitation teams an accurate prediction of survival 15 minutes into a resuscitation attempt. Conclusion: Data collection and analysis of cardiopulmonary resuscitation attempts are essential for the formulation of survival indicators. In this case the data have enabled the formulation of a survival predictor scale that will quantify the decision making process regarding the termination of cardiopulmonary resuscitation attempts.