A new study published in the journal The BMJ Open has found that the chances of a person surviving while receiving cardiopulmonary resuscitation (CPR) for cardiac arrest in a hospital rapidly decrease from 22% after one minute to less than 1% after 39 minutes. Similarly, the probability of leaving the hospital without major brain damage decreases from 15% after one minute of CPR to less than 1% after 32 minutes without a heartbeat. Researchers say the findings provide information that can help guide hospital teams, patients and their families in deciding how long to continue resuscitation.
In-hospital cardiac arrest is a common and catastrophic medical emergency, and only about 25% of patients survive to hospital discharge. Studies have shown that longer resuscitation time for patients with in-hospital cardiac arrest is linked to lower chances of survival, but experts have not been able to make specific recommendations about when to stop resuscitation.
To address this knowledge gap, researchers measured the effect of CPR duration (in minutes) on outcomes for 348,996 U.S. adults (average age 67) who suffered in-hospital cardiac arrest between 2000 and 2021.
CPR was defined as the interval between the start of chest compression and the first return of spontaneous circulation (ROSC) or completion of resuscitation.
The main measures of interest were survival to hospital discharge and favorable functional outcome at hospital discharge, defined as a brain performance score of one (good brain performance) or two (moderate brain disability) on a five-point scale.
After taking into account potentially influential factors such as age, sex, ethnicity and a variety of pre-existing conditions, the results show that of the 348,996 patients, 233,551 (67%) achieved return of spontaneous circulation with an average duration of seven-minute CPR. , while 115,445 (33%) did not achieve return of spontaneous circulation with a mean CPR duration of 20 minutes. With one-minute CPR, the odds of survival and favorable functional outcome among patients were 22% and 15%, respectively.
But as the duration of CPR increased, the odds of survival and favorable functional outcome decreased to less than 1% for survival at 39 minutes and less than 1% for favorable functional outcome at 32 minutes.