Few survive cardiac arrest, even with CPR
MILWAUKEE - The odds of surviving cardiac arrest after getting CPR in a hospital are slim and have not improved in more than a decade, a large Medicare study concludes.
Only about 18 percent of such patients live long enough to leave the hospital, researchers found. Blacks fared worse than whites, a disparity only partly explained by more of them being treated in hospitals that did a poorer job of cardiopulmonary resuscitation.
Results were published in today’s New England Journal of Medicine.
Dr. Lance Becker, a University of Pennsylvania emergency medicine specialist and an American Heart Association spokesman, called the findings “grim’’ and “a wake-up call that we need to redouble our efforts’’ to find better ways to treat cardiac arrest.
It occurs when the heart quivers or stops beating entirely, because of a heart attack, a sudden heart rhythm problem, a drug overdose, or other cause.
CPR, rhythmic chest compressions, can help maintain blood pressure and flow until more advanced treatments can be tried. Those might involve using a defibrillator to shock the heart back into a normal rhythm. Big strides have been made in getting bystanders to do cardiopulmonary resuscitation and to use defibrillators, but the new study suggests that less improvement in the nation’s hospitals.
Researchers led by Dr. William Ehlenbach at the University of Washington in Seattle analyzed the care of 433,985 Medicare patients treated from 1992 through 2005 in the United States.
Survival odds did not substantially change over time, they found. Blacks had survival rates about one-quarter lower than whites. Men, older patients, and people admitted from nursing homes also had lower survival rates after CPR. The study was funded by grants from the federal government and several foundations.
“It’s troubling. We have made a lot of progress in out-of-hospital cardiac arrest,’’ including a near tripling of survival rates in the Seattle area after community and rescue worker training efforts, said Dr. Paul S. Chan. He is a quality-of-care researcher at St. Luke’s Mid America Heart Institute in Kansas City, Mo.
His own research, published in the New England journal last year, found one-third of hospitalized patients do not get a potentially live-saving defibrillator shock within the recommended two minutes of cardiac arrest.