CPR in hospitalized patients: when is it futile?

Abstract

When cardiac or pulmonary arrest occurs in hospitalized patients, cardiopulmonary resuscitation (CPR) is often futile. Although "do-not-resuscitate" orders are widely used and presumably screen out many patients who are poor candidates for CPR, recent studies have shown that an average of only 13 percent of patients receiving CPR in the hospital survive to discharge. An average of 4 percent of patients receiving CPR in general ward settings survive. Of those who do survive after CPR, many are in a persistent vegetative state or a chronic dependent condition. Patients with malignancy, sepsis, pneumonia, renal failure, diabetes or advanced age have a low chance of surviving after CPR. It is important for both patients and physicians to make a realistic appraisal of the likely outcome of CPR.