Identification of a potentially avoidable cardiopulmonary resuscitation in hematology and oncology wards

• Published in: BMC palliative care Vol. 18; no. 1; p. 93
• Main Authors: Choi, Yeonjoo, Kim, Jin Won, Suh, Koung Jin, Lim, Yoo-Joo, Lee, Ji Yun, Kang, Beo-Deul, Kim, Ji-Won, Kim, Se-Hyun, Lee, Jeong-Ok, Kim, Yu Jung, Lee, Keun-Wook, Kim, Jee Hyun, Bang, Soo-Mee, Lee, Jong Seok
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04.11.2019; BioMed Central; BMC
• Subjects: Aged; Aged, 80 and over; Analysis; Cancer; Cancer patients; Cancer treatment; Cardiopulmonary arrest; Cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - statistics & numerical data; Chemotherapy; Do-not-resuscitate orders; Female; Health Status; Heart Arrest - etiology; Heart Arrest - therapy; Hematologic Neoplasms - complications; Hospice Care; Hospital Mortality; Hospitals - statistics & numerical data; Humans; Lung cancer; Lymphomas; Male; Medical records; Middle Aged; Neoplasms - complications; Physicians; Potentially avoidable; Prognosis; Republic of Korea; Resuscitation; Resuscitation Orders; Risk Factors; Sex Factors; Tumors; Republic of Korea; Potentially avoidable; Prognosis; Cardiopulmonary arrest; Resuscitation; Cancer
• ISSN: 1472-684X; 1472-684X
• DOI: 10.1186/s12904-019-0477-7

In-hospital cardiopulmonary resuscitation (CPR) is one of undesirable situations. We tried to identify and characterize a potentially avoidable CPR in cancer patients who were hospitalized in hematology and oncology wards. A potentially avoidable CPR was determined based on chemotherapy setting, disease status and clinical situation at the time when a cardiopulmonary arrest occurred, by using a consensus-driven medical records review of two physicians. One hundred thirty-seven patients among 12,437 patients hospitalized at hematology and oncology wards between March 2003 and June 2015 (1.1%) underwent a CPR. Eighty-eight patients (64.2%) were men. The majority of patients with a CPR had lung cancer (41, 29.9%), hematologic malignancy (24, 17.5%), stomach cancer (23, 16.8%) or lymphoma (20, 14.6%). A potentially avoidable CPR was identified in 51 patients (37.2%). In a multivariate analysis, advanced diseases and certain tumor types (e.g., lung cancer, lymphoma) were significant risk factors for a potentially avoidable CPR. Of patients who received a potentially avoidable CPR, 29 patients (56.9%) did not have a do-not-resuscitate documentation. A first return of spontaneous circulation rate (ROSC) and in-hospital survival rate (IHSR) were much lower in patients with a potentially avoidable CPR than those with a CPR that was not avoidable (ROSC: 39.2% vs 53.5%, P = 0.106; IHSR: 2.0% vs 12.8%, P = 0.032, respectively). A potentially avoidable CPR was common at hematology and oncology wards. A potentially avoidable CPR frequently occurred in advanced diseases and certain tumor types. Furthermore, cancer patients who received a potentially avoidable CPR showed the worse prognosis.