Today's issue of the New England Journal of Medicine in cludes this article by William Ehlenbach and colleagues at the University of Washington-Seattle: "Epidemiologic Study of In-Hospital Cardiopulmonary Resuscitation in the Elderly."
The authors identified 433,985 patients (Medicare beneficiaries 65 years of age or older) who underwent in-hospital CPR and found:
Only 18% of these patient survived to discharge -- a rate that did not change substantially during the period from 1992 through 2005
The proportion of in-hospital deaths preceded by CPR increased, whereas the proportion of survivors discharged home after undergoing CPR decreased
The overall incidence of CPR was higher among black and other nonwhite patients
The authors rightly express concern that "the proportion of patients who died in the hospital after having previously undergone in-hospital CPR has increased during a time of more education and awareness about the limits of CPR in patients with advanced chronic illness and life-threatening acute disease."