Cardiac arrest & resuscitation
Frailty and Outcomes Following Cardiopulmonary Resuscitation for Perioperative Cardiac Arrest
Main finding · 30-day mortalityResult — go to the resultAdjusted odds ratio 1.35 95% CI 1.11–1.65Authors' conclusion
The findings of this cohort study suggest that although roughly 1 in 3 patients with an RAI of 40 or greater survived at least 30 days following perioperative CPR, higher frailty burden was associated with increased mortality and greater risk of nonhome discharge among survivors.
Study context
- Population
- Patients ≥50 y undergoing noncardiac surgery who received cardiopulmonary resuscitation (CPR) on POD 0, >700 US hospitals, 2015–2020included in the analysis
- Participants
- 3,149 patients
- Exposure
- Frailty vs Risk Analysis Index (RAI) <40
- RAI ≥40n = 792
- Outcome
- Thirty-day mortality and nonhome discharge
- Follow-up
- 30 days
Methodological detailslongitudinal, multicentre registry (ACS NSQIP), Follow-up duration 30 days, Data from American College of Surgeons National Surgical Quality Improvement Program, January 1, 2015, through December 31, 2020
- Longitudinal
- Multicentre registry (ACS NSQIP)
- Follow-up duration 30 days
- Data from American College of Surgeons National Surgical Quality Improvement Program, January 1, 2015, through December 31, 2020
Main finding
30-day mortality
Adjusted odds ratio
1.35
95% CI 1.11–1.65
P = 0.003
Events by group
RAI ≥40
67.4%
534 of 792
Frailty (RAI ≥40) vs RAI <40
aOR 1.35 (95% CI 1.11–1.65); P = 0.003
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Nonhome discharge | 1.85 (1.31–2.62) | P < 0.001 | |
| 0.20.5125Adjusted odds ratio (log scale) |
30-day mortality, nonemergent procedures (subgroup)
| aOR (95% CI) | ||
|---|---|---|
| FrailtyFrailty vs no frailty | 1.55 (1.23–1.97) | |
| 0.512Adjusted odds ratio (log scale) |
30-day mortality, emergent procedures (subgroup)
| aOR (95% CI) | ||
|---|---|---|
| FrailtyFrailty vs no frailty | 0.97 (0.68–1.37) | |
| 0.512Adjusted odds ratio (log scale) |
- 30-day mortality, nonemergent procedures (subgroup): P = .03 for interaction
- 30-day mortality, emergent procedures (subgroup): P = .03 for interaction
Mortality and nonhome discharge by RAI (spline regression)
- Steadily increasing probability of mortality and nonhome discharge with increasing RAI above 37 and 36, respectively
Original publication
Frailty and Outcomes Following Cardiopulmonary Resuscitation for Perioperative Cardiac Arrest. JAMA Netw Open. Published 3 July 2023. doi:10.
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