Acute cardiac care & resuscitation
Hesitate to resuscitate? A cohort study of hesitation to initiate resuscitation for in-hospital cardiac arrests
Authors' conclusion
Hesitation to initiate CPR in IHCA occur, particularly among older patients admitted in general wards. Hesitation relates to lack of resuscitation decisions or staff expressing an opinion that a DNACPR decision should have been made prior to the IHCA. This suggests that the routine around discussions and decisions of DNACPR orders could be improved.
Study context
- Population
- Patients aged 18 and over with in-hospital cardiac arrest (IHCA) in the Swedish Registry of Cardiopulmonary Resuscitation, 2007–2023patients with IHCA
- Participants
- 36,471 patients
- Exposure
- Hesitation vs non-hesitation to initiate Cardiopulmonary Resuscitation (CPR)
- Hesitationn = 2,757
- Outcome
- Hesitation ratio
Methodological detailsbased on data from the Swedish Registry of Cardiopulmonary Resuscitation, inductive qualitative content analysis of free text comments
- Based on data from the Swedish Registry of Cardiopulmonary Resuscitation
- Inductive qualitative content analysis of free text comments
Main finding
As reported in the abstract
Hesitation ratio
8%
n = 2757
Observational data: associations, not effects.
Further findings
Mean age
P < 0.01
| Outcome | P value |
|---|---|
| Hesitation ratio by wardGeneral wards vs Intensive care units · higher in general wards | P < 0.01 |
- Hesitation ratio by ward: General wards 11%
- Hesitation ratio by ward: Intensive care units 3%
Variables with hesitation ratio over 10%
- Age, ongoing myocardial infarction, general ward, non-ECG-surveillance and unwitnessed
- over 10%
Grounds for hesitation (qualitative)
- Most commonly due to a prior Do-not-attempt CPR (DNACPR) order or a wish from the staff to have such, some related to age or comorbidity but none related to frailty
Original publication
Hesitate to resuscitate? A cohort study of hesitation to initiate resuscitation for in-hospital cardiac arrests. Resuscitation. Published 7 March 2025. doi:10.
Summarised from the published abstract; every number is checked against it