Predictors of survival after cardiopulmoner resuscitations performed in the emergency department

The aim of this study is to define the characteristics of cardiac arrest patients who underwent CPR in the emergency department (ED) and to detect the relevant early predictors of survival or prognostic factors after CPR. Chart reports of patients who underwent CPR in the ED of Akdeniz University Hospital between 2010 and 2012 were evaluated retrospectively. Traumatic cardiac arrest patients and patients younger than 18 years were excluded from the study. Patients who underwent CPR were divided as out of hospital and in-hospital cardiac arrests. Demographical, clinical and laboratory criteria affecting survival in the ED and in hospital after admission to the hospital were analyzed. It was found that the number of nontraumatic arrests who underwent CPR was 260 within three years time. The average survival to hospital admission of 126 in-hospital arrests (arrests occurred in the emergency department and hospital outpatient clinics areas) was 34.1%, and survival to hospital discharge was 10.0%. Factors affecting survival to admission was younger age, VF / pulseness VT as the initial rhythm, the duration of CPR that is shorter than 30 minutes, the first PCO2 over 45 mmHg and creatinine level less than 1.2 mg/dl. Factors determining survival to hospital discharge was age, absence of comorbid diseases, VF / pulseness VT as the initial rhythm, administration of 3 mg or less adrenaline, the first hemoglobin above 10 mg / dL and creatinine levels of less than 1.2 mg /dL. The necessity of establishing recording system and its standardization will help us to identify predictors of survival from cardiac arrests and to improve the resuscitation outcomes. Further studies should be done to standardize the data gathering of hospital cardiac arrest and to determine the effect of medical care on survival after the return of spontaneous circulation