Outcomes of in-hospital cardiopulmonary resuscitation for patients with end-stage liver disease.
Liver Int. 2019 Feb 27;:
Authors: Ufere NN, Brahmania M, Sey M, Teriaky A, El-Jawahri A, Walley KR, Celi LA, Chung RT, Rush B
BACKGROUND AND AIMS: There have been improving survival trends after in-hospital cardiac arrest for the general population, but there is limited information on the outcomes of hospitalized patients with end-stage liver disease (ESLD) who undergo cardiopulmonary resuscitation (CPR). We aimed to examine survival to hospital discharge after receipt of in-hospital CPR in patients with ESLD using a nationally representative sample.
METHODS: We used the Nationwide Inpatient Sample database from 2006-2014 to identify adult patients who underwent in-hospital CPR. Using multivariate modeling, we compared survival to hospital discharge for patients with ESLD to those without ESLD. We also compared outcomes of patients with ESLD to patients with metastatic cancer.
RESULTS: A total of 177,533 patients underwent in-hospital CPR, of which 1,474 (0.8%) had ESLD. Patients with ESLD had lower rates of survival to hospital discharge compared to patients without ESLD (10.7% vs. 28.6%, p<0.01). In multivariate modeling, ESLD was significantly associated with lower odds of survival to hospital discharge after in-hospital CPR (OR 0.35, 95% CI 0.28-0.44, p<0.01). Amongst survivors of in-hospital CPR, ESLD patients had a significantly lower chance of discharge to home compared to patients without ESLD (3.2% vs. 8.0%, p<0.05). Patients with ESLD also had lower rates of survival to hospital discharge compared to those with metastatic cancer (10.7% vs. 15.5%, p<0.01).
CONCLUSIONS: Outcomes are poor after in-hospital CPR in patients with ESLD and are worse than for patients with metastatic cancer. The current analysis can be used to inform goals of care discussions for patients with ESLD. This article is protected by copyright. All rights reserved.
PMID: 30809903 [PubMed - as supplied by publisher]