FACTORS AFFECTING MORTALITY IN CPR

DILBER ÜÇÖZ KOCAŞABAN1, AHMET BURAK ERDEM2, BAHATTIN IŞIK3

¹Ankara Training and Research Hospital, Department of Emergency Medicine, 06100 Ankara, Turkey - ²Health Sciences University Ankara Numune Training and Research Hospital, Emergency Medicine Clinic, Ankara, Turkey - ³Health Sciences University Ankara Dişkapi Training and Research Hospital, Emergency Medicine Clinic, Ankara, Turkey

Aim: We analyzed factors affecting the mortality of patients resuscitated in our emergency department (ED) and post-resuscita- tion mortality over time.

Materials and methods: We analyzed the effects of age, gender, admission time (month and hour), trauma history, admission type, cardiac rhythm type (shockable versus non-shockable), and interventions (intubation, resuscitation, defibrillation, and medical treat- ment) on mortality in the ED and during transport to the ED. The effects of hospitalization diagnosis, duration, and unit on hospitalized patient mortality after resuscitation were also analyzed.

Results: The median age of the 1,097 patients included in the study was 67 years, and 62.6% of the patients were male. Of the patients, 37.5% responded to resuscitation in the ED. No effect of age was found on admission month and resuscitation success in the ED (p>0.05). The response to resuscitation of male patients, patients admitted from 12 am to 6 am, non-traumatic patients, patients who presented to the ED independently, and patients with shockable rhythms was high (p<0.05). We identified an increase in resuscitation success with adrenaline, atropine, and amiodarone (p<0.05). Mortality in the ED was affected by gender, adrenaline, and defibrillation to a statistically significant degree (p<0.05).

Thirty-day mortality was 96% in our study. Patients who died during hospitalization were older on average than those who did not (p<0.05). The mortality of patients admitted from 12 am to 6 am and of patients who presented to the ED independently was low (p<0.05). No significant correlation was found between the mortality of hospitalized patients and age; admission month; severity of con- dition (traumatic versus non-traumatic); interventions in the ED or during transportation to the ED; or hospitalization diagnosis, dura- tion, or unit (p>0.05). There were no statistically significant correlations between 30-day mortality and patient age; gender; admission month; severity of condition; intubation in the ambulance; resuscitation; cardiac rhythm; cardiac interventions in the ED; or hospitali- zation diagnosis, duration, or unit (p>0.05).

Conclusions: Many factors affecting mortality in the ED and in hospitalized patients were identified. The most important factor affecting response to resuscitation in the ED was found to be defibrillation and time elapsed prior to interventions.