Evidence map›Paper›PMID 30484100›Full record

Observational studyJournal of general internal medicine2019

Predictors Associated with Survival Among Elderly In-Patients Who Receive Cardiopulmonary Resuscitation in Japan: An Observational Cohort Study.

Tetsuro Hayashi, Masato Matsushima, Seiji Bito, Natsuko Kanazawa, Norihiko Inoue, Sarah Kyuragi Luthe, Christina C Wee

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of general internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.3field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 11 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 2 countries.

Tetsuro HayashiDivision of Clinical Epidemiology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan. thayashi@ntmc-hosp.jp.
Masato MatsushimaDivision of Clinical Epidemiology, The Jikei University School of Medicine, Tokyo, Japan.
Seiji BitoDivision of Clinical Epidemiology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
Natsuko KanazawaDepartment of Clinical Data Management and Research, Clinical Research Center, National Hospital Organization Headquarters, Tokyo, Japan.
Norihiko InoueDepartment of Clinical Data Management and Research, Clinical Research Center, National Hospital Organization Headquarters, Tokyo, Japan.
Sarah Kyuragi LutheDepartment of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
Christina C WeeGeneral Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
National Hospital Organization · JPTokyo Medical and Dental University · JPAsahikawa Medical University · JPBeth Israel Deaconess Medical Center · USJikei University School of Medicine · JP

Funding

Patient Oriented Research and Mentorship Program in ObesityK24DK087932 · NIDDK · BETH ISRAEL DEACONESS MEDICAL CENTER · PI WEE, CHRISTINA C · 2011 to 2015
$955k
NIDDK NIH HHS K24 DK087932
6 · The paper itself

Abstract

backgroundLittle is known about the outcomes of in-hospital cardiopulmonary resuscitation (CPR) in Asian populations including elderly patients in Japan.

objectiveTo determine the survival outcome of in-hospital CPR among elderly patients in Japan, and to identify predictors associated with survival.

designRetrospective cohort study in 81 Japanese hospitals from April 1, 2010 to March 31, 2016. PATIENTS: We included elderly patients (age ≥ 65 years) who received CPR after 2 days of hospitalization. MAIN MEASURES: The primary outcome was survival at hospital discharge and the secondary outcomes were the discharge disposition and consciousness level of patients who survived to hospital discharge. To determine predictors associated with survival after in-hospital CPR, we fit multivariable models for patient-level and institutional-level factors. KEY

resultsAmong the 5365 patients who received CPR, 595 (11%) survived to discharge. Of those who survived to discharge, 46% of patients were discharged home, and 10% of patients were comatose at discharge. Older age and higher burden of comorbidities were associated with reduced survival. The adjusted OR was 0.35 (95% CI, 0.22-0.55) for age ≥ 90 years compared to age 65-69 years, and 0.68 (95% CI, 0.48-0.97) for Charlson Comorbidity Index score of ≥ 4 compared with score of 0. Other predictors of reduced survival included receiving CPR on weekends compared to weekdays (AOR, 0.63; 95% CI, 0.51-0.77) and in small hospitals compared to large hospitals (AOR, 0.58; 95% CI, 0.40-0.83).

conclusionsAmong elderly patients in Japan, the survival rate of in-hospital CPR was approximately one in ten, and less than half of these patients were discharged home. In addition to older age and higher illness burden, receiving CPR on weekends and/or in small hospitals were significant predictors of reduced survival. These findings should be considered in advanced care planning discussions with elderly patients to avoid subjecting patients to CPR that are likely futile.

Indexed as

AgedAged, 80 and overCardiopulmonary ResuscitationCohort StudiesFemaleHeart ArrestHospital MortalityHumansJapanMalePredictive Value of TestsRetrospective StudiesSurvival Rateagingdecision makingend-of-life careevidence base medicine

Identifiers

PMID30484100
PMCPMC6374261
OpenAlexW2902656671

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.