Retrospective investigation of factors affecting cardiopulmonary resuscitation success

The aim of our study was to retrospectively analyze patients who underwent in-hospital cardiopulmonary resuscitation (CPR) and to determine the factors affecting survival. The records of 1576 patients who underwent CPR in 2016 at the Bursa Uludağ University Health Practices Research Center were reviewed after the approval of the ethics committee. The characteristics of the patients and the CPR application were recorded, the values of the scoring systems were calculated using this information. In patients undergoing CPR, the rate of return of spontaneous circulation (ROSC) was 32.41%, survival rates at first 24 and 48 hours were 8,15% and 7,46%, discharge rate was 1,54%, the rate of survival during hospitalization of 398 patients with ROSC was 5,36%. For determining the rate of ROSC; the duration of hospital stay (OR:95%Cl; 0,99:0,98-1,00), intensive care unit (OR:95%Cl; 0.64:0.47-0.88) and emergency department arrest (OR:95%Cl; 0.09:0.03-0.28), sepsis (OR:95%Cl; 0.19:0.13-0.28), metastasic malignancy (OR:95%Cl; 0.16:0,11-0,24), impaired liver function (OR:95%Cl; 0,52:0,32-0,83) and presence of respiratory depression (OR:95%Cl; 1,79:1,21-2,67), VF/nVT as initial rhythm on ECG (OR:95%Cl; 8,13:4,32-15,28; 23,04:8,73-60,80 respectively), urea value (OR:95%Cl; 1,00: 1,00-1,00), SPO₂ value (OR:95%Cl; 1,13:1,09-1,18) were independent risk factor. Cardiac arrest occurred in the intensive care unit (OR:95%Cl; 3.01:1.37-6.62; 4.57:1.75-11.96, 6,79:2,32-19,86 respectively) and increased SAPS II scores (OR:95%Cl; 1,06:1,03-1,09; 1,09:1,04-1,13; 1,10:1,05-1,15 respectively) in patients who death in the first 24 hours, 48 hours and during hospitalization following ROSC; in addition to the high values of GOFAR (in order of: OR:95%Cl; 0,95:0,91-0,99; 0,94:0,90-0,99) and PAR (in order of OR:95%Cl; 1,17:1,06-1,30; 1,15:1,04-1,29) scores in patients who death in the first 48 hours and during hospitalization have also affected mortality rates in a negative way. In conclusion, in patients undergoing CPR for in-hospital cardiac arrest, GOFAR and PAR scores, as well as SAPS II score can be used in prediction of survival. Furthermore, it has been shown that arrest in intensive care unit is one of the leading factors affecting survival poorly. Keywords: In-hospital cardiac arrest, cardiopulmonary resuscitation, prognostic factors, scoring systems, survival