Muhammad Naeem Aslam, Humera Jawad, Muhammad Sarfraz, Ghazanfar Ali Sindhu, Yousaf Hassan, Safdar Ali Bajwa.
Outcome of Cardiopulmonary Resuscitation in hospital patients following heart attack.
Pak J Cardiol Jan ;15(3):116-24.
The aim of this study was to evaluate in hospital survival of the patients admitted or presenting in cardiac emergency room with cardiac arrest as well as to look into the factors associated with success rate of CPR. Methods: Prospective study of consecutive 404 patients admitted in cardiac emergency room who received advance cardiac life support protocol after in-hospital cardiac arrest. Short term survival (Return of spontaneous respiration and circulation) and hospital survival at the time of discharge were measured. In addition, factors affecting the outcome of CPR age, gender, duration of CPR, associated arrhythmias, defibrillation and TPM implantation were also taken in account. Main outcome: Immediate survival after CPR, at 24 hours and at the time of discharge. Results: Overall 134 out of 404 patients (33%) who received advanced cardiopulmonary life support, survived to hospital discharge. Survival was better in male i.e. 37% versus 26% in female. Younger age group showed better survival i.e. 40.4% in age range of 30 to Department of Cardiology, Punjab Medical College, Allied Hospital Faisalabad. 49 years, 33% in 50 to 69 years and 28% in 70 years or older. Survival rate was 86% when CPR duration was less than 10 minutes, at 15 minutes 48% and at 20 minutes CPR time, 25% patients survived. Only 13.9% patients survived at CPR time of 30 minutes. Survival was 42% for patients with VF and 68% in those presenting with VT, 61% in fast AF with hemodynamic instability. 29% patients having TPM implantation survived of cardiac arrest. Poor survival in patients of cardiac arrest presenting with new development of LBBB i.e. 18%, best in inferior wall STEMI (32%), intermediate in anterior wall STEMI (28%). Total of 40 patients in cardiogenic shock had cardiac arrest and 17.5% resuscitated successfully. Conclusion: Survival was highest for patients with primary cardiac arrest, with short CPR duration, young age, male gender and with tachyarrhythmia. Patients who experienced cardiac arrest at cardiac emergency room have better survival. Survival was poor in patients with cardiogenic shocks, CPR duration more than 20 minutes.
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