Cardiopulmonary resuscitation for hospital inpatients in Taiwan: an 8-year nationwide survey.

AIM

Cardiopulmonary resuscitation (CPR) is widely used to treat cardiac arrest, but the success rate has remained unchanged for decades. This study evaluated CPR performance and success rate among hospital inpatients in Taiwan.

METHODS

National Health Insurance data from 1997 to 2004 of population-based datasets representing 5% of the total hospitalizations in Taiwan were analyzed. CPR and the disease entities of patients receiving CPR were defined according to the International Classification of Disease, 9th version. Comparisons between cancer and non-cancer diagnoses were done.

RESULTS

The cumulative incidence of in-hospital CPR was 10.8 per 1000 admissions (11,710/1,086,795), and gradually decreased. The most significant decrease in CPR was in 2000 when the Hospice Palliative Care Act was implemented. The overall CPR success rate was 14.8% (1738/11,710), and non-cancer patients had a significantly higher chance to survive with CPR (1588/10,413, 15.3%) than cancer patients (150/1297, 11.6%) (P<0.001). CPR success rate was lowest in patients with infectious diseases (8%) and highest in patients with obstetrical or gynaecological conditions (47%). Rates of receiving resuscitation in cancer and non-cancer patients dropped by 58.3% and 16.4%, respectively, during the study period.

CONCLUSION

The significant reduction in CPR during hospitalization may reflect implementation of a national "Do Not Resuscitate" policy. Predictive factors of successful CPR among hospital inpatients and the determinants of appropriate withholding of CPR remain unclear.