INTRODUCTION:Cardiopulmonary resuscitation is thought to be a low-yield intervention in cancer patients. In patients with metastatic disease the procedure is thought to be futile. Comprehensive data on survival to discharge in subsets of cancer patients undergoing in-hospital cardiopulmonary resuscitation, however, are lacking. OBJECTIVE:To determine the rate of survival to discharge for adult cancer patients undergoing in-hospital cardiopulmonary resuscitation. METHOD:A systematic search of MEDLINE and our primary sources' references was performed for studies involving in-hospital cardiac arrest, in clearly defined subsets of adult cancer patients, with outcomes that included survival to hospital discharge. RESULTS:Forty-two studies from 1966-2005, comprising 1707 patients met our minimal inclusion criteria. Overall survival to discharge was 6.2%. Survival in patients with localized disease was 9.5%, and in patients with metastatic disease was 5.6%. Analysis of data reported since 1990 reveals a narrowing of the survival gap, with survival rates in patients with localised disease of 9.1%, and in patients with metastatic disease of 7.8%. Survival in patients resuscitated on the general medical/surgical wards was 10.1%, while survival in patients resuscitated on intensive care units (ICUs) was 2.2%. CONCLUSIONS:Overall survival of CPR to hospital discharge in cancer patients compares favorably to survival rates in unselected inpatients. Improved outcomes in recent years in patients with metastatic disease are likely to reflect more selective use of CPR in cancer patients, with the sickest patients deselected.

译文

简介:心肺复苏被认为是癌症患者的低产干预措施。在患有转移性疾病的患者中,该过程被认为是徒劳的。然而,缺乏关于接受医院内心肺复苏的癌症患者亚群中出院生存率的综合数据。
目的:确定接受院内心肺复苏的成年癌症患者的出院生存率。
方法:对MEDLINE和我们主要来源的参考文献进行系统搜索,以研究涉及明确定义的成年癌症患者亚组中院内心脏骤停的研究,其结果包括生存至出院。
结果:1966年至2005年的42项研究(包括1707名患者)符合我们的最低纳入标准。出院总生存率为6.2%。局部疾病患者的生存率为9.5%,转移性疾病患者的生存率为5.6%。自1990年以来报告的数据分析显示,生存差距正在缩小,局部疾病患者的生存率为9.1%,转移性疾病患者的生存率为7.8%。在普通内科/外科病房复苏的患者的存活率为10.1%,而在重症监护病房(ICU)进行复苏的患者的存活率为2.2%。
结论:癌症患者到出院时CPR的总生存率优于未选择住院患者的生存率。近年来,转移性疾病患者转归的改善可能反映了癌症患者对CPR的更多选择性使用,而最病患者被取消了选择。

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