FitzGerald J D, Wenger N S, Califf R M, Phillips R S, Desbiens N A, Liu H, Lynn J, Wu A W, Connors A F, Oye R K
Department of Medicine, UCLA 90095, USA.
Arch Intern Med. 1997 Jan 13;157(1):72-6.
To describe functional outcomes of seriously III patients who survived 2 months after in-hospital cardiopulmonary resuscitation (CPR) and to identify patient and clinical characteristics associated with worse functional status after CPR.
Multicenter prospective observational analysis of 162 seriously ill hospitalized patients who survived 2 months after CPR. Analysis of clinical characteristics associated with worse functional outcome.
Among 162 survivors of in-hospital CPR, 56% had the same or improved function and 44% had worse function at 2 months compared with functional status before CPR. Patients with worse function deteriorated by a mean of 3.9 activities of daily living and were less likely to survive to hospital discharge (P < .001) or to 6 months after study entry (P < .001). Worse functional outcome was associated with greater age and longer hospital stay before CPR.
More than half of CPR survivors had preserved functional status 2 months after CPR. However, patients with worse function are profoundly disabled. In anticipation of possible severe disability after CPR, preferences for care in such health states should be discussed with patients before the need for CPR, particularly among older patients and those with long hospital stays.
描述在院内心肺复苏（CPR）后存活2个月的重症患者的功能转归，并确定与CPR后功能状态较差相关的患者及临床特征。
对162例在CPR后存活2个月的重症住院患者进行多中心前瞻性观察分析。分析与功能转归较差相关的临床特征。
在162例院内CPR幸存者中，与CPR前的功能状态相比，56%的患者功能相同或有所改善，44%的患者在2个月时功能较差。功能较差的患者日常生活活动能力平均下降3.9项，且存活至出院（P<0.001）或研究入组后6个月（P<0.001）的可能性较小。功能转归较差与年龄较大及CPR前住院时间较长有关。
超过一半的CPR幸存者在CPR后2个月功能状态得以保留。然而，功能较差的患者存在严重残疾。鉴于CPR后可能出现严重残疾，应在需要CPR之前与患者讨论对此类健康状态下的护理偏好，尤其是老年患者和住院时间较长的患者。
