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Outcomes of Cardiopulmonary Resuscitation in the Elderly

Donald J. Murphy, MD; Anne M. Murray, MD; Bruce E. Robinson, MD; and Edward W. Campion, MD
[+] Article, Author, and Disclosure Information

Grant Support: Supported in part by the Hebrew Rehabilitation Center for Aged; and grant AG00599 and an NIA Teaching Nursing Homes Award, AG04390, from the U.S. Public Health Service.

Requests for Reprints: Donald J. Murphy, MD, ICU Research Unit, 2300 K Street, NW, Washington, DC 20037.

Current Author Addresses: Dr. Murphy: ICU Research Unit, 2300 K Street, NW, Washington, DC 20037.

Dr. Murray: Division of Geriatrics, Beth Israel Hospital, 330 Brookline Avenue, Boston, MA 02215-5491.

Dr. Robinson: 12901 North Bruce B. Downs Boulevard, Box 19, Tampa, FL 33612.

Dr. Campion: 10 Shattuck Street, Boston, MA 02115.

© 1989 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1989;111(3):199-205. doi:10.7326/0003-4819-111-3-199
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Study Objective: To determine the success rate of cardiopulmonary resuscitation in the elderly and to define characteristics of elderly patients for whom cardiopulmonary resuscitation is effective.

Design: Retrospective chart review.

Setting: Five Boston health-care institutions: two acute-care hospitals; two chronic-care hospitals; and one long-term-care institution.

Patients: Five hundred and three consecutive patients aged 70 and over who received cardiopulmonary resuscitation.

Measurements and Main Results: Of 503 patients, 112 (22%) survived initially but only 19 (3.8%) survived to hospital discharge. The poorest outcomes were for patients with unwitnessed arrests (1 of 116 survived), terminal arrhythmias such as asystole and electromechanical dissociation (1 of 237 survived), and patients with cardiopulmonary resuscitation lasting more than 15 minutes (1 of 360 survived). Only 2 (0.8%; CI, 0.0% to 2.0%) of 244 patients with out-of-hospital cardiopulmonary arrests left the hospital alive. Of 259 patients with in-hospital arrests, 17 (6.5%; CI, 3.4% to 9.6%) survived to discharge. Most survivors had ventricular arrhythmias and were resuscitated within minutes. Initial survivors with either impaired consciousness or functional impairment after the arrest had significantly worse chances of survival than patients without these impairments

Conclusion: Cardiopulmonary resuscitation is rarely effective for elderly patients with cardiopulmonary arrests that are either out-of-hospital, unwitnessed, or associated with asystole or electromechanical dissociation.





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