Predicting survival, in-hospital cardiac arrests: Resuscitation survival variables and training effectiveness

Aim: the purpose of this study was to determine the key factors influencing survival from cardiopulmonary resuscitation and to analyse the effectiveness of a resuscitation training programme. Method: a prospective analysis of all cardiopulmonary resuscitation attempts was performed over a period of 3 years. Included in the study were 808 in hospital cardiac arrests, on whom a full cardiopulmonary resuscitation attempt was performed. Immediate, 23 h and discharge survival rates were the main outcome measures. Results: the immediate survival rate was 43.2%, then 30.2% at 24 h, and 21.9% by discharge. Multivariate analysis of all variables showed that the key factors influencing immediate survival were the 'duration of the arrest', the 'primary arrhythmia', 'basic life support within 3 min of an arrest', 'age less than 70 years', 'the primary mode of arrest-respiratory or cardiac' and 'difficulties with equipment and staff skills during a resuscitation'. Resuscitation training over the 3 year period was shown to have been effective, with improved survival rates on the wards and a reduced number of serious difficulties at arrests. Conclusion: data collection and analysis of cardiopulmonary resuscitation attempts are essential for the formulation of survival indicators, and the subsequent training of resuscitation teams. (C) 1997 Elsevier Science Ireland Ltd.