# 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.

## Key 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.