Open AccessThe incidence and survival after in-hospital cardiopulmonary cerebral resuscitation in end-stage kidney disease patients: A nationwide population-based study
Author(s) -
ChiaHung Yang,
JiaJin Chen,
JiunTing Yeh,
George Kuo,
ChengChia Lee,
IChang Hsieh,
MingJer Hsieh,
Ya-Chung Tian,
ChihHsiang Chang
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0238029
Subject(s) - medicine , cardiopulmonary resuscitation , incidence (geometry) , renal replacement therapy , population , survival rate , kidney disease , resuscitation , emergency medicine , physics , environmental health , optics
Background This study analyzed the survival and protective predictors of in-hospital cardiopulmonary cerebral resuscitation (CPCR) to potentially help physicians create effective treatment plans for End-stage kidney disease (ESKD) patients. Methods We extracted the data of 7,116 ESKD patients who received their first in-hospital CPCR after initial dialysis between 2004 and 2012 from the National Health Insurance Research Database. The primary outcome was the survival rate during the first in-hospital CPCR. The secondary outcome was the median post-discharge survival. Results From 2004 through 2012, the incidence of in-hospital CPCR decreases from 3.97 to 3.67 events per 1,000 admission days ( P for linear trend <0.001). The survival rate for the first in-hospital CPCR did not change significantly across the 9 years ( P for trend = 0.244), whereas the median survival of post-discharge survival increased significantly from 3.0 months in 2004 to 6.8 months in 2011 ( P for linear trend <0.001). In addition, multivariable analysis identified older age as a risk factor and prior intracardiac defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) implantation as a protective factor for in-hospital death during the first in-hospital CPCR. Conclusion The incidence of in-hospital CPCR and the duration post-discharge among ESKD patients improved despite there being no significant difference in the survival rate of ESKD patients after CPCP. Either ICD or CRT-D implantation may be advisable for ESKD patients with a high risk of sudden cardiac death.