Cardiopulmonary resuscitation outcomes in a cancer center emergency department

BACKGROUND: Cardiopulmonary resuscitation (CPR) after cardiac arrest is utilized indiscriminately among unselected populations. Cancer patients have particularly low rates of return of spontaneous circulation (ROSC) and survival to hospital discharge after CPR. Our study determines rates of ROSC and survival to hospital discharge among cancer patients undergoing CPR in our cancer center. We examined whether these rates have changed over the past decade. METHODS: This IRB-approved retrospective observational study was conducted in our cancer center. The ED and cancer center provide medical care for ≥ 115,000 patients annually. Cases of CPR presenting to the cancer center for years 2003–2012 were identified using Institutional CPR and Administrative Data for Resuscitation and Billing databases. Age, gender, ethnicity, ROSC and Discharge Alive using a modified Utsein template was used to compare proportions achieving ROSC and survival to hospital discharge for two time periods: 2003–2007 (Group 1) and 2008–2012 (Group 2), using traditional Pearson chi-square statistics. RESULTS: One hundred twenty-six cancer center patients received CPR from 2003–2012. Group 1 (N = 64) and Group 2 (N = 62) were similar; age (60 vs. 60 years), gender (63% vs. 58% male), and race/ethnicity (67% vs. 56% White). Proportions achieving ROSC were similar in the two time periods (36% Group 1 vs. 45% Group 2, OR = 1.47, 95% CI 0.72 - 3.00) as was survival to hospital discharge (11% Group 1 vs. 10% Group 2, OR 0.87, 95% CI 0.28 - 2.76). CONCLUSIONS: ROSC after CPR in cancer patients and survival to hospital discharge did not change over time.