Descriptive analysis of contributing factors in outcomes of emergency department CPRs

Introduction

CPR can avoid 25% of deaths especially out-of-hospital cases. Cases of cardiac arrest are usually studied from epidemiological aspects. This study is designed to guide us through our Emergency Department (ED) and EMS managements.

Methods and materials

In this observational cross-sectional study, 195 patients admitted to the ED of Rasoul Akram hospital during 11 month from June 2003 to April 2004 were included. Age, sex, time, place, cause and witness of arrest, BLS/ALS, out-of-hospital intubations, transportation vehicle, CPR outcome and final status of patients were gathered in a data registration form.

Results

The mean (± standard error of the mean) age was 59.33 ± 1.4, there was a significant difference in mean age between males and females (P = 0.003). A total 41.5% of cases arrested in the ED, 14.9% had no witness, 56.4% were transported to hospital by ambulance, 53.3% received no life support before arrival and 13.3% had been intubated out of hospital. The first rhythm checked in the ED was asystole in 73.3%. Cardiovascular problems constituted 42.1% of causes. There was a significant difference in cause of cardiac arrest between age groups (P = 0.000). A total 59.5% of CPRs were successful; there was no significant difference in sex (P = 0.199) and age (P = 0.746) groups and different cause categories. CO poisoning and hanging had maximal mortality (100%). Age, sex distribution (P = 0.07), time of cardiac arrest, place of collapse (P = 0.1), cause of arrest, being witnessed, performed BLS/ALS (P = 0.7), intubations (P = 0.76), initial cardiac rhythm, and transportation vehicle had no effects on patients final status. CPR outcome (P = 0.000) and the cause of arrest (P = 0.000) affected the final status of patients. Finally, 93.3% of patients expired and 6.7% of patients were discharged from hospital.

Discussion

Successful CPR was performed in the majority of cases. But the overall prognosis was poor. The main determining factor of final status was the cause of arrest.