Analysis of cardiopulmonary resuscitation outcomes among critically ill patients at a university hospital, Kafr-El-Sheikh Governorate
Authors: Khedr Hamada A.E.M. , Morsy Warda Y.M. , Elreheim Fatma S.A.A. , Zahra Ahmed M. 
Published: May 2024

Background

Cardiopulmonary resuscitation (CPR) is a vital intervention in managing critically ill patients experiencing cardiac arrest (CA). Understanding the factors influencing CPR outcomes is crucial for optimizing resuscitation strategies and improving patients’ survival rates.

Aim

To analyze the outcome of CPR among critically ill patients.

Research questions

To fulfill the aim of this study, four research questions were formulated.

Design

A descriptive exploratory research design was used.

Setting

Three ICUs affiliated to a university hospital in Kafr-El-Sheikh, Egypt.

Sample

A purposive sample that included 69 CA patients for 7 months, and a convenience sample of 97 members of the emergency response team working at the above-mentioned setting.

Tools

Three tools were formulated.

Results

The highest age category (31.9%) of CA patients was of 61–70 years. Over 7 months, the frequency of CA among critically ill patients was 7.61%. Regarding ICUs’ preparedness, institutional factors affecting emergency readiness had an unsatisfactory practice level (mean±SD=17.04±2.10), and crash cart preparedness was at mean±SD=30.42±4.32. The study showed unsatisfactory practice levels related to International Liaison Committee on Resuscitation 2020 guidelines for total advanced cardiac life support (ACLS) performance with a mean score and SD of 87.81±18.19. Patient outcomes showed a 10.1% overall survival rate at ICU discharge, 82.6% experiencing return of spontaneous circulation, and 89.9% experiencing brain death. Clinical high-risk scores against National Early Warning Score 2 were 98.2 and 88.2% on the first and last days, respectively. Poor cerebral performance category outcome scores were found at 96.5 and 88% on the first and last days, respectively. However, there were insignificant statistical correlations (P>0.05) between different patients’ outcomes and total adult ACLS role during CA based on International Liaison Committee on Resuscitation guidelines 2020.

Conclusion

CA among critically ill patients creates a significant burden for healthcare facilities and continues to be associated with a high mortality rate. The institutional factors affecting CPR outcomes among CA patients concerning preparedness level have a significant influence on survival. Conversely, the majority of resuscitated patients experienced return of spontaneous circulation, indicating successful initial efforts with severe neurological disability.

Recommendations

Hospital preparedness for CA situations has to be severely considered through implementing and regularly reviewing institutional policies and ensuring the availability and functionality of necessary resources. Update regular continuous educational programs toward enhancing the performance of emergency response team focusing on ACLS guidelines. Replication of this study on a larger probability sample from different geographical locations in Egypt is recommended.