Abstract: FR-PO399
Association of CPR Duration with Discharge Outcomes in Maintenance Dialysis Patients
Session Information
- Hemodialysis and Frequent Dialysis - III
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Saeed, Fahad, University of Rochester Medical Center, Pittsford, New York, United States
- Murad, Haris Farooq, Yale School of Medicine, New Haven, Connecticut, United States
Background
Cardiopulmonary resuscitation (CPR) is associated with high mortality rates in patients receiving maintenance dialysis. There are no large studies to date that relate the duration of CPR to discharge outcomes in these patients.
Methods
Using electronic medical records, we identified all the adult patients (≥18years) who underwent CPR and were admitted to the hospital from January 2006 to December 2014 and then used chart review to select patients who were on maintenance dialysis. The charts documented CPR duration, CPR characteristics, in-hospital mortality, and discharge to home. In multivariate analyses, candidate variables were patient demographics, dialysis duration, number of co-morbidities, in-hospital vs out-of-hospital CPR, and initial heart rhythm.
Results
Of the 402 ESRD patients who had undergone CPR, duration of CPR was documented in 296 patients. Among these, CPR duration was ≤10 minutes in 111 patients and >10 minutes in 185 patients. Of those who had received CPR ≤10 minutes, 46.2% died within the same hospitalization; of patients receiving CPR >10 minutes, 83.2% died within the same hospitalization. Those receiving CPR for >10 minutes had higher odds of in-hospital death (OR 8.91 4.44, 17.89,p=<.0001) and survivors had lower odds of discharge to home (OR 0.08, 0.01,0.63, p=0.017) after adjusting for confounding variables.
Conclusion
Longer CPR duration was independently associated with poor discharge outcomes. These data may help clinicians determine prognostic information to guide discussions with families. Moreover, It may be appropriate to limit the CPR duration in patients deemed to have a poor prognosis.