Sehatzadeh S
Ont Health Technol Assess Ser. 2014 Dec 1;14(15):1-38. eCollection 2014.
Cardiopulmonary resuscitation (CPR) was first introduced in 1960 for people who unexpectedly experience sudden cardiac arrest. Over the years, it became routine practice in all institutions to perform CPR for all patients even though, for some patients with fatal conditions, application of CPR only prolongs the dying process through temporarily restoring cardiac function.
This analysis aims to systematically review the literature to provide an accurate estimate of survival following CPR in patients with terminal health conditions.
A literature search was performed for studies published from January 1, 2004, until January 10, 2014. The search was updated monthly to March 1, 2014.
Abstracts and full text of studies that met eligibility criteria were reviewed. Reference lists were also examined for any additional relevant studies not identified through the search.
Cancer patients have lower survival rates following CPR than patients with conditions other than cancer, and cancer patients who receive CPR in intensive care units have one-fifth the rate of survival to discharge of cancer patients who receive CPR in general wards. While the meta-analysis of studies published between 1967 and 2005 reported a lower survival to discharge for cancer patients (6.2%), more recent studies reported higher survival to discharge or to 30-day survival for these patients. Higher survival rates in more recent studies could originate with more "do not attempt resuscitation" orders for patients with end-stage cancer in recent years. Older age does not significantly decrease the rate of survival following CPR while the degree, the type, and the number of chronic health conditions; functional dependence; and multiple CPRs (particularly in advanced age) do reduce survival rates. Emergency Medical Services response time have a significant impact on survival following out-of-hospital CPR.
Survival after CPR depends on the severity of illness, type and number of health conditions, functional dependence, and multiple CPRs.
1960年首次引入心肺复苏术（CPR）用于意外发生心脏骤停的患者。多年来，对所有患者实施心肺复苏术已成为所有医疗机构的常规做法，尽管对于一些患有致命疾病的患者，实施心肺复苏术只是通过暂时恢复心脏功能来延长死亡过程。
本分析旨在系统回顾文献，以准确估计患有终末期健康状况的患者心肺复苏术后的生存率。
对2004年1月1日至2014年1月10日发表的研究进行文献检索。该检索每月更新至2014年3月1日。
对符合纳入标准的研究的摘要和全文进行综述。还检查参考文献列表，以查找通过检索未识别出的任何其他相关研究。
癌症患者心肺复苏术后的生存率低于非癌症患者，在重症监护病房接受心肺复苏术的癌症患者出院生存率仅为在普通病房接受心肺复苏术的癌症患者的五分之一。虽然对1967年至2005年间发表的研究进行的荟萃分析报告癌症患者出院生存率较低（6.2%），但最近的研究报告这些患者出院生存率或30天生存率较高。最近研究中较高的生存率可能源于近年来对晚期癌症患者下达更多“不进行心肺复苏”医嘱。年龄较大并不会显著降低心肺复苏术后的生存率，而慢性健康状况的程度、类型和数量；功能依赖；以及多次心肺复苏（尤其是高龄患者）确实会降低生存率。紧急医疗服务响应时间对院外心肺复苏术后的生存率有显著影响。
心肺复苏术后的生存取决于疾病的严重程度、健康状况的类型和数量、功能依赖以及多次心肺复苏。
