Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
OUTCOMES OF CARDIOPULMONARY-RESUSCITATION IN NURSING-HOMES - CAN WE PREDICT WHO WILL BENEFIT
Autore:
TRESCH DD; NEAHRING JM; DUTHIE EH; MARK DH; KARTES SK; AUFDERHEIDE TP;
Indirizzi:
MED COLL WISCONSIN,DIV CARDIOL,8700 W WISCONSIN AVE MILWAUKEE WI 53226 MED COLL WISCONSIN,ZABLOCKI VET ADM MED CTR,DEPT CARDIOL MILWAUKEE WI53226 MED COLL WISCONSIN,ZABLOCKI VET ADM MED CTR,DEPT GERIATR GERONTOL MILWAUKEE WI 53226 MED COLL WISCONSIN,ZABLOCKI VET ADM MED CTR,DEPT EMERGENCY MED MILWAUKEE WI 53226 MED COLL WISCONSIN,ZABLOCKI VET ADM MED CTR,DEPT FAMILY MED MILWAUKEEWI 53226
Titolo Testata:
The American journal of medicine
fascicolo: 2, volume: 95, anno: 1993,
pagine: 123 - 130
SICI:
0002-9343(1993)95:2<123:OOCIN->2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
HOSPITAL CARDIAC-ARREST; AGE; FIBRILLATION; CPR;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
28
Recensione:
Indirizzi per estratti:
Citazione:
D.D. Tresch et al., "OUTCOMES OF CARDIOPULMONARY-RESUSCITATION IN NURSING-HOMES - CAN WE PREDICT WHO WILL BENEFIT", The American journal of medicine, 95(2), 1993, pp. 123-130

Abstract

PURPOSE: To determine the benefits of cardiopulmonary resuscitation (CPR) in nursing home patients and assess possible prearrest and arrestpredictors of survival. PATIENTS AND METHODS: During a 4-year period (1986 to 1989), consecutive nursing home patients from Milwaukee, Wisconsin, who sustained cardiac arrest and received CPR by paramedics were studied. The patients' prearrest clinical characteristics were determined including age, length of stay in nursing home, medical diagnoses, medications, circumstances surrounding the arrest, laboratory studies, and baseline functional status. Cardiac arrest data were obtained from a paramedic computer data base and included whether the arrest waswitnessed, initial cardiac rhythm, and success of CPR. Survival was defined as the discharge of the patient alive from the hospital, and the patient's pre- and post-arrest functional status was compared. Possible predictors of survival were analyzed from the patient's prearrest characteristics and arrest characteristics. RESULTS: Of the total 196 patients who received CPR, 37 (19%) were successfully resuscitated andhospitalized, and 10 (5%) survived to be discharged. However, 27% of patients survived whose arrests were witnessed and who demonstrated ventricular fibrillation at the time of the arrest. In comparison, only 2.3% of all other nursing home patients who received CPR survived (p <0.0002). Age, mental or functional status, hematocrit, renal dysfunction, pulmonary disease, cancer, and cardiovascular disease were not significant predictors of survival. At the time of hospital discharge, the functional status of the majority (80%) of the survivors was comparable to their prearrest status and 40% of the survivors lived for greater than 12 months. CONCLUSION: We conclude that only a small percentage of nursing home patients who sustain cardiac arrest will benefit from CPR. However, greater than 25% of nursing home patients whose arrest is witnessed and who demonstrate ventricular fibrillation will survive. This is comparable to the survival rate of elderly community-dwelling persons who sustain cardiac arrest. Our data suggest that CPR should be initiated only in nursing home patients whose cardiac arrest is witnessed and should only be continued in patients whose initial documented cardiac rhythm is ventricular fibrillation or ventricular tachycardia.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/07/20 alle ore 22:12:21