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CPR Survival Rates for Older People Unchanged

Lack of improvement in death rates, experts say, may be because recipients are sicker

By Serena Gordon
HealthDay Reporter


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WEDNESDAY, July 1 (HealthDay News) -- Despite efforts to fine-tune the procedure for cardiopulmonary resuscitation, or CPR, the survival rate for older people given CPR has not changed much in recent decades, new research has found.

Just 18 percent of adults older than 65 who received CPR while in the hospital survived long enough to be discharged, according to a new study in the July 2 issue of the New England Journal of Medicine. However, during the study period, from 1992 to 2005, the number of people in this age group who were given CPR before they died jumped 37 percent -- from 3.8 percent in 1992 to 5.2 percent in 2005.

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"Although significant efforts have been made to improve CPR, we found ... no significant change in survival," said the study's lead author, Dr. William Ehlenbach, a senior fellow at the University of Washington in Seattle.

That's probably because the population is sicker, he said.

"People are living longer with chronic disease," Ehlenbach said. "And, in people 65 and older, it's more common to have multiple, serious chronic illnesses that are less survivable than an acute illness."

"CPR has the highest likelihood of success when the heart is the reason, as in an ongoing heart attack or a heart rhythm disturbance," he explained. "If you're otherwise doing well, CPR will often be successful. But, if you're in the ICU [intensive care unit] with a serious infection and multiple organ failure, it's unlikely that CPR will save you."

Another reason that CPR survival rates have not improved, he said, is that some people who are given CPR probably shouldn't be because it will not significantly extend their life and might prolong their death and suffering.

"People are very commonly surprised at the likelihood of survival after CPR," Ehlenbach said. "Doctors and other health-care providers need to have discussions about end-of-life care and the role of CPR in end-of-life care. This study highlights the need for improved education and communication about end-of-life care."

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Copyright © 2009 ScoutNews, LLC. All rights reserved.
Last updated 7/1/2009

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SOURCES: William J. Ehlenbach, M.D., M.Sc., senior fellow, University of Washington, Seattle; Daniel Brauner, M.D., associate professor, medicine, University of Chicago Medical Center, Chicago; July 2, 2009, New England Journal of Medicine


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