(HealthDay News) — For patients with in-hospital cardiac arrest (IHCA), survival outcomes are similar for those on maintenance dialysis and nondialysis patients, according to a study published online in the Clinical Journal of the American Society of Nephrology.
Monique Anderson Starks, MD, from Duke University Medical Center in Durham, North Carolina, and colleagues examined the association of IHCA and outcomes by dialysis status among patients with end-stage kidney disease receiving maintenance dialysis from 2000 to 2012 and matched nondialysis patients. Data were included for 31,144 Get-With-The-Guidelines Resuscitation registry patients, 27.2% of whom were maintenance dialysis patients.
The researchers found that dialysis patients were less likely to have a shockable initial rhythm than nondialysis patients (19.8 vs 20.7%). Lower composite scores for resuscitation quality (88.9 vs 89.7) and lower likelihood of defibrillation within two minutes (53.9 vs 58.2%) were seen for maintenance dialysis patients. After adjustment, compared with nondialysis patients, maintenance dialysis patients had similar adjusted odds of survival to discharge (odds ratio [OR], 1.05; 95% confidence interval [CI], 0.97 to 1.13), had better acute survival (OR, 1.33; 95% CI, 1.26 to 1.40), and were more likely to have favorable neurological status (OR, 1.12; 95% CI, 1.04 to 1.22).
“Our study suggests that cardiopulmonary resuscitation is not a futile intervention in dialysis patients with IHCA,” the authors write.
One author disclosed financial ties to the pharmaceutical industry.
Anderson Starks M, Wu J, Peterson ED, et al. In-Hospital Cardiac Arrest Resuscitation Practices and Outcomes in Maintenance Dialysis Patients. Clin J Am Soc Nephrol. doi:10.2215/CJN.05070419
Hsu SI, Wong SPY. Reconciling Short- and Long-Term Outcomes of In-Hospital Cardiac Arrest in Patients undergoing Maintenance Dialysis. Clin J Am Soc Nephrol. doi:10.2215/CJN.14121119