Predictors of cardiopulmonary arrest outcome in a comprehensive cancer center intensive care unit
1 Section of Critical Care Medicine, Department of Internal Medicine, School of Medicine, Texas Tech University Health Sciences Center, 1400 S. Coulter Street, Amarillo, Texas, 79106, USA
2 Department of Internal Medicine, School of Medicine, University of Arizona, Tucson, AZ, USA
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2013, 21:18 doi:10.1186/1757-7241-21-18Published: 20 March 2013
Some comprehensive cancer centers in industrialized countries have reported improved outcomes in their cardiopulmonary arrest (CPA) patients. Little is known about the outcomes and predictors of CPA in cancer centers in other parts of the world. The objective of this study was to examine the predictors of CPA outcome in a comprehensive cancer center closed medical-surgical intensive care unit (ICU) located in Amman, Jordan.
In this retrospective single-center cohort study, we identified 104 patients who had a CPA during their stay in the ICU between 1/1/2008 and 6/30/2009. Demographic data and CPA-related variables and outcome were extracted from medical records. Comparisons between different variables and CPA outcome were conducted using logistic regression.
The mean age of the group was 49.7 ± 15.3 years. The mean APACHE II score was 23.7 ± 8.0. Thirty six patients (34.6%) were resuscitated successfully but 8 of them (7.7% of the cohort) left the ICU alive and only 6 out of the 8 (5.8% of the cohort) left the hospital alive. The following variables predict resuscitation failure: acute kidney injury (OR 1.7, CI: 1.1 – 2.6), being on mechanical ventilation (OR 3.8, CI: 1.3 – 11), refractory shock (OR 4.7, CI: 1.8 – 12) and CPR duration (OR 1.1, CI: 1.1 – 1.2).
Survival among cancer patients who develop CPA in the ICU continues to be poor. Once cancer patients suffered a CPA in the ICU multiple factors predicted resuscitation failure but CPR duration was the only factor that predicted resuscitation failure and ICU as well as hospital mortality.