Hamza Mustufa Khan, Hania Ahmer, Sajjeel Ahmed, Ibrahim Bhatti, Saad Altaf, Ibrahim Bin Huzaifa, Abdul Sattar.
Survival outcome of Chronic Kidney Disease patients who underwent Cardiopulmonary Resuscitation in the Emergency Department.
South Asian J Emerg Med Jan ;3(2):18-21.

OBJECTIVE: The purpose of this study was to determine the survival outcome of CPR (Cardiopulmonary resuscitation) in patients with Chronic Kidney Disease who underwent cardiopulmonary resuscitation in emergency department. METHODOLOGY: This retrospective observational cohort study was conducted in a tertiary care hospital in Islamabad Pakistan. All the patients who underwent cardiopulmonary resuscitation over a period of three years were included in the study. All patients who were dead on arrival or whose ages were less than 16 years, were excluded from the study. Patients with CKD were isolated and were labeled as chronic kidney disease (CKD) group (Group A). For the rest of the patients, a similar number of patients were isolated by a consecutive sampling technique labelled as a non-CKD group (Group B). Mortality in the Emergency department and survival to discharge was calculated. Charlson Comorbidity Index was used to compare the mortality outcome in both groups. RESULTS: From January 2017 to December 2020, we reviewed data from 439 patients, all of whom had undergone resuscitation attempts in the Emergency Department (ED). Out of these, 76 patients were received dead and 5 didn`t have proper documentation of the outcome of resuscitation. From the remaining pool of 258 patients, 18 patients also remove from the study who were less than 16 years. 84 patients had chronic kidney disease (CKD Group) group A while 86 patients were randomized by consecutive sampling technique in non- CKD group (Group B). In the CKD group, 23 (27.3 %) patients expired in an emergency, while in the Non-CKD group 28 (32.5%) patients expired in an emergency. Survival to discharge in patients who were admitted to the hospital was much better in CKD group 14 (16.2 %) than in Non-CKD group28 (33.3%). Charlson Comorbidity Index (CCI) was also calculated for both almost identical groups. The mean CCI for the non-CKD group was 3.12 (SD = 1.20) and the mean CCI for the CKD group was 1.05 (SD = 1. 47). Comparison of the mean by independent sample T-test showed statistically significant (P= 0.01) results. CONCLUSION: Survival of in-hospital cardiac arrest patients who undergo Cardiopulmonary resuscitation in an emergency is multifactorial but patients with CKD may have a better outcome due to more reversible causes provided other comorbid conditions are similar.

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