Navigation Links
CPR Survival Rates for Older People Unchanged
Date:7/1/2009

Lack of improvement in death rates, experts say, may be because recipients are sicker,,,,

WEDNESDAY, July 1 (HealthDay News) -- Despite efforts to fine-tune the procedure for cardiopulmonary resuscitation, or CPR, the survival rate for older people given CPR has not changed much in recent decades, new research has found.

Just 18 percent of adults older than 65 who received CPR while in the hospital survived long enough to be discharged, according to a new study in the July 2 issue of the New England Journal of Medicine. However, during the study period, from 1992 to 2005, the number of people in this age group who were given CPR before they died jumped 37 percent -- from 3.8 percent in 1992 to 5.2 percent in 2005.

"Although significant efforts have been made to improve CPR, we found ... no significant change in survival," said the study's lead author, Dr. William Ehlenbach, a senior fellow at the University of Washington in Seattle.

That's probably because the population is sicker, he said.

"People are living longer with chronic disease," Ehlenbach said. "And, in people 65 and older, it's more common to have multiple, serious chronic illnesses that are less survivable than an acute illness."

"CPR has the highest likelihood of success when the heart is the reason, as in an ongoing heart attack or a heart rhythm disturbance," he explained. "If you're otherwise doing well, CPR will often be successful. But, if you're in the ICU [intensive care unit] with a serious infection and multiple organ failure, it's unlikely that CPR will save you."

Another reason that CPR survival rates have not improved, he said, is that some people who are given CPR probably shouldn't be because it will not significantly extend their life and might prolong their death and suffering.

"People are very commonly surprised at the likelihood of survival after CPR," Ehlenbach said. "Doctors and other health-care providers need to have discussions about end-of-life care and the role of CPR in end-of-life care. This study highlights the need for improved education and communication about end-of-life care."

The researchers reviewed Medicare data on people age 65 and older who were hospitalized between 1992 and 2005. They found that 433,985 people were given in-hospital CPR during that time and that 18.3 percent of them survived until discharged.

More black and other non-white patients were given CPR, the study found, but the survival rate was about 24 percent lower for black than for white patients. Ehlenbach said the researchers were somewhat surprised by this finding and did further analysis to see whether the rate varied depending on the facility where someone was hospitalized.

In other words, were minorities receiving care in hospitals that had lower rates of survival after CPR? The study found that the "difference seems to be a hospital effect," Ehlenbach said.

Dr. Daniel Brauner, an associate professor of geriatrics and palliative medicine at the University of Chicago Medical Center, said that disparities in health care might very well play a role in the racial differences found in the study, but that those differences also might indicate a need for increased education and communication.

"In this study, blacks are requesting almost twice the rate of CPR," Brauner said. "They don't want 'do not resuscitate' orders."

"The reasons for this are probably multifold," he said. "Some may not have had access to health care in the past, and now that they do, they want to make use of all of the technologies. The other part of it is a trust issue. You really have to be able to trust your physician" when making end-of-life care decisions.

The study also found that people who survived CPR were less likely to go home than in the past. Instead, more were ransferred to longer-term care facilities.

"Sometimes it's in your best interest to forego CPR," Brauner said. "There is a burden that comes with getting these therapies. And, if you're at the end stage of a chronic illness, CPR isn't going to change that. There are much more pleasant ways to approach end-of-life care."

More information

The American Heart Association has more on CPR.



SOURCES: William J. Ehlenbach, M.D., M.Sc., senior fellow, University of Washington, Seattle; Daniel Brauner, M.D., associate professor, medicine, University of Chicago Medical Center, Chicago; July 2, 2009, New England Journal of Medicine


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Conventional prognostic factors fail to explain better prostate cancer survival in most Asian men
2. Survival differences by race most apparent in advanced stages of breast cancer
3. Prophylactic cranial irradiation in small cell lung cancer significantly increases survival
4. Human C-reactive protein regulates myeloma tumor cell growth and survival
5. Mediterranean Diet May Boost Alzheimers Survival
6. Hospitals Improve Survival Rates While Treating Sicker Patients Thomson Healthcare Study Shows
7. The Fight for His Life: Author, Family Battle Disease and Challenge Politics in the Face of Survival
8. Communication in cancer world is key to survival
9. Molecular profiling can accurately predict survival in colon cancer patients
10. New chemotherapy regimen prolongs survival in difficult-to-treat childhood brainstem gliomas
11. Phase II study shows HRPC patients with bone metastases see improved survival with ZD4054
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
CPR Survival Rates for Older People Unchanged
(Date:5/27/2016)... ... May 27, 2016 , ... ... is bolstered by inspiring human-interest stories, courtesy of awareness-driven celebrities and thought leaders. ... from leading advocates, associations and industry leaders such as Bioness. , As ...
(Date:5/27/2016)... ... May 27, 2016 , ... ... is bolstered by inspiring human interest stories, courtesy of leaders in the nursing ... tech within the industry, from leading advocates and associations—namely Jones & Bartlett Learning. ...
(Date:5/27/2016)... ... ... With a team of certified experts, Validation Center is ... GMP accreditation, Validation Center is also a registered authority of the international system ... Validation Center is ISO17025 accredited and only offers its clients the latest technology, ...
(Date:5/26/2016)... ... May 26, 2016 , ... W.S. Badger Co. Inc ., the maker ... 2016 When Work Works Award for its use of effective workplace strategies to increase ... Works project administered by the Families and Work Institute (FWI) and the Society for ...
(Date:5/26/2016)... ... May 26, 2016 , ... Georgia State University College of ... programs. , Answering to the increasing demand for curricular specializations, the Certificate in ... environmental and land use law. ,  , “The demand for lawyers with specific ...
Breaking Medicine News(10 mins):
(Date:5/25/2016)... , May 25, 2016  According to Kalorama Information, ... billion in 2015.  Though these are challenging times ... opportunity for success for companies that remain optimistic ... of new growth prospects medical device companies spend ... and development (R&D) than do companies in other ...
(Date:5/25/2016)... 25, 2016 Digital Health Dialog, LLC ... by the US Patent and Trademark Office of ... proprietary processes for electronic opt-­in and processing of ... programs, HIPAA compliance and otherwise. Logo - ... "Our technology allows for individuals to ...
(Date:5/24/2016)... , May 24, 2016 ... Markt gebracht, die es Ärzten erlaubt, ihre Expertise ... behandeln: MDLinking kombiniert Live Streaming mit einer Instant-Messaging-Funktion ... zu kommunizieren. Mediziner in Europa, Afrika, Asien und ... bereits für die Plattform registriert. Information ...
Breaking Medicine Technology: