Outcomes of in-hospital cardiopulmonary resuscitation in maintenance dialysis patients

Fahad Saeed, Malik Adil, Ahmed A. Malik, Jesse D. Schold, Jean L. Holley

Research output: Contribution to journalArticle

Abstract

Outcomes of cardiopulmonary resuscitation (CPR) in hospitalized patients with ESRD requiring maintenance dialysis are unknown.Outcomes of in-hospital CPR in these patients were compared with outcomes in the general population using data from the Nationwide Inpatient Sample (NIS; 2005-2011). The study population included all adults (≤18years old) fromthe general population and thosewith a history of ESRD. Baseline characteristics, in-hospital complications, and discharge outcomes were compared between the two groups. The effects of in-hospital CPR on mortality, length of stay, hospitalization charges, and discharge destination were analyzed. Yearly national trends in survival, discharge to home, and length of stay were also examined using the Cochran-Armitage trend test. During the study period, 56,069 patients with ESRD underwent in-hospital CPR compared with 323,620 patients from the general population. Unadjusted in-hospital mortality rates were higher in patients with ESRD (73.9% versus 71.8%, P<0.001) on univariate analysis. After adjusting for age, gender, and potential confounders, patients with ESRD had higher odds of mortality (odds ratio, 1.24; 95% confidence interval, 1.11 to 1.3; P<0.001). Survival after CPR improved in the year 2011 compared with 2005 (31%versus 21%, P<0.001).Multivariate analysis also revealed that a greater proportion of patients with ESRD who survived were discharged to skilled nursing facilities. In conclusion, outcomes after in-hospital CPR are improving in patients with ESRD but remain worse than outcomes in the general population. Patients with ESRD who survive are more likely to be discharged to nursing homes.

Original languageEnglish (US)
Pages (from-to)3093-3101
Number of pages9
JournalJournal of the American Society of Nephrology
Volume26
Issue number12
DOIs
StatePublished - Dec 1 2015
Externally publishedYes

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Cardiopulmonary Resuscitation
Dialysis
Chronic Kidney Failure
Maintenance
Population
Mortality
Length of Stay
Skilled Nursing Facilities
Survival
Hospital Mortality
Nursing Homes
Inpatients
Hospitalization
Multivariate Analysis
Odds Ratio
Confidence Intervals

ASJC Scopus subject areas

  • Nephrology

Cite this

Outcomes of in-hospital cardiopulmonary resuscitation in maintenance dialysis patients. / Saeed, Fahad; Adil, Malik; Malik, Ahmed A.; Schold, Jesse D.; Holley, Jean L.

In: Journal of the American Society of Nephrology, Vol. 26, No. 12, 01.12.2015, p. 3093-3101.

Research output: Contribution to journalArticle

Saeed, Fahad ; Adil, Malik ; Malik, Ahmed A. ; Schold, Jesse D. ; Holley, Jean L. / Outcomes of in-hospital cardiopulmonary resuscitation in maintenance dialysis patients. In: Journal of the American Society of Nephrology. 2015 ; Vol. 26, No. 12. pp. 3093-3101.
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abstract = "Outcomes of cardiopulmonary resuscitation (CPR) in hospitalized patients with ESRD requiring maintenance dialysis are unknown.Outcomes of in-hospital CPR in these patients were compared with outcomes in the general population using data from the Nationwide Inpatient Sample (NIS; 2005-2011). The study population included all adults (≤18years old) fromthe general population and thosewith a history of ESRD. Baseline characteristics, in-hospital complications, and discharge outcomes were compared between the two groups. The effects of in-hospital CPR on mortality, length of stay, hospitalization charges, and discharge destination were analyzed. Yearly national trends in survival, discharge to home, and length of stay were also examined using the Cochran-Armitage trend test. During the study period, 56,069 patients with ESRD underwent in-hospital CPR compared with 323,620 patients from the general population. Unadjusted in-hospital mortality rates were higher in patients with ESRD (73.9{\%} versus 71.8{\%}, P<0.001) on univariate analysis. After adjusting for age, gender, and potential confounders, patients with ESRD had higher odds of mortality (odds ratio, 1.24; 95{\%} confidence interval, 1.11 to 1.3; P<0.001). Survival after CPR improved in the year 2011 compared with 2005 (31{\%}versus 21{\%}, P<0.001).Multivariate analysis also revealed that a greater proportion of patients with ESRD who survived were discharged to skilled nursing facilities. In conclusion, outcomes after in-hospital CPR are improving in patients with ESRD but remain worse than outcomes in the general population. Patients with ESRD who survive are more likely to be discharged to nursing homes.",
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