The outcomes of cardiopulmonary resuscitation in a medical intensive care unit

Purpose: The purpose of this study is to define the outcome of cardiopulmonary resuscitation in a medical intensive care unit (MICU). The true mortality rate with confidence intervals will be determined and estimates of resource utilization will be presented. Methods: Using a clinical data base that captures demographic, clinical, physiologic and outcomes information a prospective observational trial was conducted on all patient admitted to the UAB MICU over a 16 month period. Patients that required cardiopulmonary resuscitation were identified, and final disposition and resource utilization was determined. Results: 62 (6.1%) of the 1017 patients admitted to the MICU from 10/94 through 2/96 required CPR. Four patients survived to hospital discharge giving a mortality rate of 93.5% (95% CI 86.7 - 100). An admitting diagnosis of arrhythmia or acute myocardial infarction was associated with survival. Only one patient without a cardiac diagnosis survived. For the patients who did not survive to hospital discharge the average number of days of survival after CPR was 2.52 days. Cost data pending. Conclusions: CPR use in a MICU has a high hospital mortality rate with significant induced resource utilization. Clinical Implications: CPR should be restricted in medical intensive care unit patients to patients most likely to benefit.