CPR Rate High In End Stage Dialysis Patients Despite Poor Outcomes

MedicalResearch.com Interview with:
Susan P. Y. Wong, M.D.
Acting Instructor & Senior Research Fellow
Division of Nephrology
University of Washington

Medical Research: What is the background for this study? What are the main findings?

Dr. Wong: There is a paucity of information on the use of cardiopulmonary resuscitation (CPR) and its outcomes among patients receiving maintenance dialysis. To address this knowledge gap, we performed a retrospective study to define contemporary trends in in-hospital CPR use and its outcomes among a nationally representative sample of 663,734 patients receiving maintenance dialysis between 2000 and 2011. We found that in-hospital CPR use among this cohort of patients was very high—nearly 20 times more common than that found in the general population. The rate of in-hospital CPR use has also been increasing among patients receiving maintenance dialysis despite evidence of poor long-term survival among these patients. Median survival after hospital discharge for members of this cohort was only 5 months, and this has not change substantially in the recent decade.

We also found that a large proportion  of dialysis patients who died in hospital settings had received CPR during their terminal hospitalization. This proportion has also been steadily increasing over time, and in 2011, 1 in 5 dialysis patients who died in hospital had received CPR during their terminal hospitalization.

Medical Research: What should clinicians and patients take away from your report?

Dr. Wong: These findings raise concern about the aggressiveness in the care that patients receiving maintenance dialysis experience near the end-of-life. This information may be helpful to patients and providers in supporting advance care planning and informed decisions about potentially life-sustaining treatments.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Wong: More research is needed on the forces driving trends in in-hospital CPR use and the degree to which CPR practices reflect patients’ treatment goals and preferences.

Citation:

 

MedicalResearch.com Interview with: Susan P. Y. Wong, M.D. (2015). CPR Rate High In End Stage Dialysis Patients Despite Poor Outcomes