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

Clin Med (Lond). 2021 Jul;21(4):e357-e362. doi: 10.7861/clinmed.2020-1002.

Abstract

Background: This study's aim was to investigate an association between outcome from in-hospital cardiopulmonary resuscitation (CPR) and increasing burden of comorbidities and frailty.

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.

Results: A total of 113 patient records were assessed. Patient frailty was assessed based on calculation of Rockwood clinical frailty score (CFS) and comorbidity assessment based on Charlson comorbidity index (CCI). A linear correlation has been identified between increasing CCI and reduced survival (ANOVA = p<0.001) and rates of return of spontaneous circulation (ROSC) (ANOVA = 0.013). No patients with a CFS above 6 survived to 1 year. A linear correlation was identified between increasing CFS and reduced probability of ROSC (ANOVA p=0.002), survival to discharge (ANOVA p=0.003) and 1 year (ANOVA p=0.001).

Conclusion: Our findings suggest an association between increasing patient multimorbidity and frailty and poorer outcome post cardiac arrest.

Keywords: Charlson; Rockwood; cardiopulmonary resuscitation; frailty; multimorbidity.

MeSH terms

  • Cardiopulmonary Resuscitation*
  • Frailty* / epidemiology
  • Hospitals
  • Humans
  • Multimorbidity
  • Retrospective Studies