Frailty, multimorbidity and in-hospital cardiopulmonary resuscitation: predictable markers of outcome?

Thomas, Elin H.; Lloyd, Aled R.; Leopold, Nicky

Methods Retrospective analysis of prospectively collected data from contemporaneous patient notes and electronic records of all patients who suffered an in-hospital cardiac arrest between 1 April 2017 and 31 March 2018 in a hospital that includes a tertiary cardiology department. KEYWORDS: frailty, cardiopulmonary resuscitation, multimorbidity, Rockwood, Charlson Introduction Despite the obvious potential benefits, cardiopulmonary resuscitation (CPR) is an invasive and often harmful treatment intervention.1 As a result of COVID-19, it is also increasingly recognised as a danger to the personnel who perform CPR.2 Incidences of adult in-hospital cardiac arrests have been demonstrated to occur in 1.6/1,000 hospital admissions and survival to hospital discharge shown in a large prospective analysis of UK National Cardiac Arrest Audit (NCAA) database to be as low as 18.4%.3 Factors such as age4 and presenting cardiac rhythm1,5 have been identified as factors that influence the likelihood of survival post-CPR, but little is known regarding the impact of the patient's frailty on their outcome post-CPR. The study population included all adults (aged over 16) who suffered an in-hospital cardiac arrest during the study period. Patients who suffered an out-of-hospital cardiac arrest (OOHCA) and those found during the resuscitation efforts to have a do not attempt cardiopulmonary resuscitation (DNACPR) order were excluded.