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Large study finds that many hospitals have been discontinuing CPR too soon

A new study published by the prestigious British medical journal, The Lancet, came to a surprising conclusion this week:  it found that most hospitals give up on CPR too early after a patient's cardiac arrest. The study (involving 64,000 cardiac arrest patients at 435 hospitals over an eight year period) noted that it has long been "established" that continuing CPR might preserve a life, but only with significant neurological deficits.  To the contrary, the investigators found that survival rates were improved with longer CPR and that neurological recovery was not changed. Between one and five of every 1,000 hospitalized patients suffers a cardiac arrest, so the issue is significant in terms of patients affected and in terms of time commitment of hospital staff.

The study authors were surprised to find a significant variation among hospitals in the median time committed to reviving arrest patients.  The median length of CPR at some hospitals was 25 minutes, but it was only 16 minutes at others.  Patients in the former group of hospitals, where typically 9 extra minutes was committed to CPR, were 12% more likely to survive and go home--and neurological function afterward between the two groups was unchanged:  patients at hospitals who provided 50% longer CPR recovered just as much function as those at hospitals where CPR was discontinued earlier.

While this is not really a "malpractice" issue--since families of a decedent could never prove that their loved one would have been one of the 12% who "should have survived" --the study should cause those hospitals who discontinue CPR early to re-evaluate their practice.  A 12% improvement in good neurological survival for an extra nine minute time commitment is not insubstantial; particularly if we are talking about your own family.

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