Survival after cardiac arrest in hospital.

A 10-year experience of cardiac arrests in a district general hospital is reviewed. 1063 arrests in the general areas of the hospital were studied, excluding the coronary and intensive care units. In 718 (67-5%) initial resuscitation was unsuccessful; in 252 (23-7%) the patient died later in hospital, 93 patients (8-7%) were discharged alive. After discharge from hospital there was a progressive annual mortality of about 7% for the first five years, but thereafter no patient died. Significant incapacity after discharge was also unusual. The probability of successful resuscitation was greater in patients with primary cardiac disease (11-8% survival), drug overdose (22-2% survival), or undergoing anaesthesia (20-0% survival). The success-rate was significantly greater in the accident and emergency department (7-9%) than on the wards (2-1%), but this difference was due entirely to the more successful resuscitation of patients with myocardial infarction in the accident and emergency department. Within each diagnostic category the survival-rate was independent of the age of the patient. Prolonged survival after resuscitation but ending in death before discharge was unusual.