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Outcomes of cardiopulmonary resuscitation in dialysis patients.

Abstract

Patients with renal failure are believed to have a poor survival rate after cardiopulmonary resuscitation, but there is little specific information about the outcomes of cardiopulmonary resuscitation in dialysis patients. To be better able to inform dialysis patients and assist them in decision making about cardiopulmonary resuscitation, the eight-year experience with cardiopulmonary resuscitation in dialysis patients at a university dialysis program was analyzed and outcomes were compared with those of a control group of nondialysis patients undergoing cardiopulmonary resuscitation during the same time period in the same hospital. Of 221 dialysis patients experiencing cardiopulmonary arrest, 74 (34%) had CPR compared with 247 (21%) of 1,201 control patients (P = 0.0002). Six of 74 (8%; 95% confidence interval, 2 to 14%) dialysis patients survived to hospital discharge compared with 30 of 247 (12%; 95% confidence interval, 8 to 16%) control patients (P = not significant). At 6 months after CPR, 2 (3%) of 74 dialysis patients were still alive compared with 23 (9%) of 247 controls (P = 0.044); this difference was not explained by age or comorbid conditions. Twenty-one (78%) of the 27 successfully resuscitated dialysis patients died a mean of 4.4 days later; 95% were on mechanical ventilation in an intensive care unit at the time of death. It was concluded that cardiopulmonary resuscitation is a procedure that rarely results in extended survival for dialysis patients. In discussions about cardiopulmonary resuscitation with dialysis patients, nephrologists should provide this information.

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  • Authors+Show Affiliations

    ,

    Center for Health Ethics and Law, West Virginia University Health Sciences Center, Morgantown 26506.

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    Source

    MeSH

    Adult
    Aged
    Cardiopulmonary Resuscitation
    Female
    Heart Arrest
    Humans
    Informed Consent
    Kidney Failure, Chronic
    Male
    Middle Aged
    Prognosis
    Renal Dialysis
    Survival Rate
    West Virginia

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    1477319

    Citation

    Moss, A H., et al. "Outcomes of Cardiopulmonary Resuscitation in Dialysis Patients." Journal of the American Society of Nephrology : JASN, vol. 3, no. 6, 1992, pp. 1238-43.
    Moss AH, Holley JL, Upton MB. Outcomes of cardiopulmonary resuscitation in dialysis patients. J Am Soc Nephrol. 1992;3(6):1238-43.
    Moss, A. H., Holley, J. L., & Upton, M. B. (1992). Outcomes of cardiopulmonary resuscitation in dialysis patients. Journal of the American Society of Nephrology : JASN, 3(6), pp. 1238-43.
    Moss AH, Holley JL, Upton MB. Outcomes of Cardiopulmonary Resuscitation in Dialysis Patients. J Am Soc Nephrol. 1992;3(6):1238-43. PubMed PMID: 1477319.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Outcomes of cardiopulmonary resuscitation in dialysis patients. AU - Moss,A H, AU - Holley,J L, AU - Upton,M B, PY - 1992/12/1/pubmed PY - 1992/12/1/medline PY - 1992/12/1/entrez SP - 1238 EP - 43 JF - Journal of the American Society of Nephrology : JASN JO - J. Am. Soc. Nephrol. VL - 3 IS - 6 N2 - Patients with renal failure are believed to have a poor survival rate after cardiopulmonary resuscitation, but there is little specific information about the outcomes of cardiopulmonary resuscitation in dialysis patients. To be better able to inform dialysis patients and assist them in decision making about cardiopulmonary resuscitation, the eight-year experience with cardiopulmonary resuscitation in dialysis patients at a university dialysis program was analyzed and outcomes were compared with those of a control group of nondialysis patients undergoing cardiopulmonary resuscitation during the same time period in the same hospital. Of 221 dialysis patients experiencing cardiopulmonary arrest, 74 (34%) had CPR compared with 247 (21%) of 1,201 control patients (P = 0.0002). Six of 74 (8%; 95% confidence interval, 2 to 14%) dialysis patients survived to hospital discharge compared with 30 of 247 (12%; 95% confidence interval, 8 to 16%) control patients (P = not significant). At 6 months after CPR, 2 (3%) of 74 dialysis patients were still alive compared with 23 (9%) of 247 controls (P = 0.044); this difference was not explained by age or comorbid conditions. Twenty-one (78%) of the 27 successfully resuscitated dialysis patients died a mean of 4.4 days later; 95% were on mechanical ventilation in an intensive care unit at the time of death. It was concluded that cardiopulmonary resuscitation is a procedure that rarely results in extended survival for dialysis patients. In discussions about cardiopulmonary resuscitation with dialysis patients, nephrologists should provide this information. SN - 1046-6673 UR - https://www.unboundmedicine.com/medline/citation/1477319/Outcomes_of_cardiopulmonary_resuscitation_in_dialysis_patients_ L2 - http://jasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=1477319 DB - PRIME DP - Unbound Medicine ER -