Cardiac arrest & resuscitation
Peri‐operative decisions about cardiopulmonary resuscitation among adults as reported to the 7th National Audit Project of the Royal College of Anaesthetists
Authors' conclusion
Very few patients who had a pre-existing 'do not attempt cardiopulmonary resuscitation' recommendation had a peri-operative cardiac arrest, and when cardiac arrest did occur, return of spontaneous circulation was achieved in 57%, although > 50% of these patients subsequently died before discharge from hospital.
Study context
- Population
- Adults (aged > 18 y) undergoing surgery in the UK; peri-operative cardiac arrests reported to NAP7activity survey
- Participants
- 20,717 adults
- Outcome
- Rates of pre-operative 'do not attempt CPR' recommendations and of peri-operative cardiac arrest in patients with such decisions
Methodological detailsactivity survey and one-year case registry, 7th National Audit Project, activity survey over four days
- Activity survey and one-year case registry
- 7th National Audit Project
- Activity survey over four days
Main finding
As reported in the abstract
Patients with a 'do not attempt CPR' recommendation pre-operatively
595
3%
Recommendations suspended
175, 29%
Cardiac arrest reports with a pre-operative 'do not attempt CPR' recommendation
54
6%
Recommendations formally suspended at time of anaesthesia and surgery (cardiac arrest cases)
25, 46%
Observational data: associations, not effects.
Further findings
Frailty among cardiac arrest patients with 'do not attempt CPR' recommendation
- Clinical frailty scale score ≥ 5
- 38 (70%)
Outcomes after cardiac arrest in patients with 'do not attempt CPR' recommendation
- Survived to leave hospital
- One in five
- ROSC achieved
- 57%
- Modified Rankin Scale unchanged among 7 with documented scores
- 4
- Modified Rankin Scale worse among 7 with documented scores
- 3
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →