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International Journal of Epidemiology 2001;30:896-898
© International Epidemiological Association 2001

Brief Report

Cardiopulmonary resuscitation performed in patients with terminal illness in Chiang Mai University Hospital, Thailand

Sudarat Sittisombuta, Edgar J Loveb and Chitr Sitthi-amornc,d

a Faculty of Nursing, Chiang Mai University, 110 Intavaroros Road, Chiang Mai 50200, Thailand.
b Department of Community Health Sciences, University of Calgary, 3330 Hospital Drive, NW, T2N 4N1 Calgary, Alberta, Canada.
c College of Public Health, Chulalongkorn University, 10th Floor, Institute Building 3, Soi Chula 62, Phyathai Road, Bangkok 10330, Thailand.
d Department of Medicine, Faculty of Medicine, Chulalongkorn University, Thailand.

Sudarat Sittisombut, Faculty of Nursing, Chiang Mai University, 110 Intavaroros Road, Chiang Mai 50200, Thailand. E-mail: sudarat{at}mail.nurse.cmu.ac.th

Abstract

Background The original target of cardiopulmonary resuscitation (CPR) was victims of acute cardiopulmonary arrest. However, the use of CPR has expanded to a wide variety of patients including those with terminal illness for whom CPR is futile. The objective of this study was to identify the incidence of CPR performed, the severity of illness and the outcome of CPR attempted in terminal illness in a teaching hospital.

Methods Cardiopulmonary resuscitation attempted in terminal illness was retrospectively assessed from the medical records of hospital deaths with any one of eight life-threatening diagnoses during a 3.5-year period.

Results Of 532 hospital deaths from terminal illness, 411 records (77.3%) were reviewed and abstracted. Most of the 411 patients had a low pre-CPR functional status. Generally, CPR was performed in 270 (65.7%) cases; 114 of those given CPR (42.2%) initially survived, but all died shortly after the manoeuvre. The high death rate following CPR may reflect both terminal illnesses and the severity of pre-event functional capacity of patients.

Conclusion The criteria for CPR in this group of patients need to be re-assessed and use of a Cerebral Performance Categories (CPC) score may be helpful.

Keywords Cardiopulmonary resuscitation, do-not-resuscitate order, terminal illness

Accepted 7 February 2001


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