Cardio pulmonary resuscitation (CPR) in the frail and those with multiple health conditions: Outcomes before and during the COVID pandemic

TL;DR

This study examines how the pandemic affected CPR outcomes in frail and multi-morbid patients, finding no significant decline in survival or return of spontaneous circulation during the pandemic.

Contribution

The study provides insights into the impact of the pandemic on CPR outcomes in vulnerable patient groups.

Findings

Similar rates of return of spontaneous circulation (ROSC) were observed before and during the pandemic.

Survival rates increased slightly during the pandemic, but the difference was not statistically significant.

Higher frailty and comorbidity scores were consistently linked to lower survival rates.

Abstract

Coronavirus 2019 (COVID-19)-era resuscitation guidelines advised personal protective equipment before chest compressions and proactive advanced care planning. We investigated the impact of COVID-19 on cardiopulmonary resuscitation (CPR) outcomes according to scoring of frailty and of multiple health conditions. A retrospective single-centre analysis of clinical and electronic records for all adult cardiac arrest calls on wards between June 2020 and June 2021 was performed. Data were compared with a cohort pre-COVID (March 2017–March 2018). In total, 62 patients received CPR in 2020–21 compared with 113 in 2017–18. Similar rates of return of spontaneous circulation (ROSC) and a statistically insignificant survival increase from 23.8% to 32.2% (p=0.210). There were linear relationships between Clinical Frailty Scale (CFS) or Charlson Comorbidity Index (CCI) and diminished survival in the pooled data (both p<0.001). Both increasing frailty (measured by CFS) and comorbidity (measured by CCI) were associated with reduced survival from CPR. However, survival and ROSC during COVID-19 were no worse than before the pandemic.

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