Chew, Keng Sheng
(2007)
A pilot study on return of spontaneous
Circulation among patients with
Cardiopulmonary resuscitation performed in
Emergency department, Hospital Universiti
Sains Malaysia.
Masters thesis, Universiti Sains Malaysia.
Abstract
Cardiopulmonary resuscitation (CPR) is an integral part of routine job
prescription for emergcncy medicine doctors. Since the 1950s, the technique of CPR is
ever improving. The introduction of the Utstein's style of reporting of outcomes or
CPR has H.1l1her enhanced standardized research works in this vital area. The
standardization of dctinitions and reporting template has also allowed more meaningful
comparison of one study with another. Dcspitc that. there has not been many published
works in this area in Malaysia. This pilot study serves to look into the effectiveness of
CPR perli.)rmed in Emergcm;y Department (ED), Hospital Univcrsiti Sains Malaysiu
(IIUSM). Two end points of this study arc
I. whether return of spontaneous circulation (ROSe) achieved regardless of
whether the Rose was sustained until admission to ward
2. whcther ROSe aehievcd and sustained until admission to ward. This is also
known as survival to admission
Methodology
This study was conducted us a prospective. observational study. All
patients with CPR done in ED. IIUSM were included in this study. The stuJy was
undertaken for a period or one yl.:i.lr. from March 2005 to March 2006. <. 'ardiac arrl.:sl
cases \\there CPR was nol pcrlilrllll.:J \-vere excluded lhllll the study. A total of 63 cardiac arrest patients were analyzed. Out of these 63
patients, 23 (36.5%) of the 63 patients were categorized as out-or-hospital Arrests
(aHA) whereas the other 40 (63.5IVo) patients had an in-hospital Arrest (II-IA).
In total. out of these 63 patients, 19 (30.2%) of them had ROSe
regardless of whether the Rose was sustained until admission to ward. The other 44
(69.8%) did not achieve ROSe at all. Only 6 patients (9.5%) achieved ROSe until
admission to ward (survival to admission) whereas the other 57 patients (90.5%) did
not.
In the aHA subgroup analysis. ROSe achieved regardless of whether it
was sustained until admission to ward is only 17.4% (11=4) and Rose achieved until
admission to ward is only 4.3% (n=l). In the lilA subgroup analysis, ROSe achieved
regardless of whether it was sustained until admission to ward is slightly better at 37.5%
(n~'I5) and ROSe achieved until admission to ward is slightly better at 12.5%) (n~5).
The chance of a patient with IliA to achieve Rose regardless of whether the ROSe
was sustained until admission to ward wu:; about two times (37S%) higher compared to
a patient with OHA (17.4%) (p:-·O.094).
Other factors found to be associated with higher chance or survival rate
arc early commencement of CPR within 5 minutes. presence or emergency physicians
during CPR. the presence or emergency medicine residents during CPR and shockable
rhythm as the initial cardiac arrest rhythm.
C
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