Outcomes, ethics and accountability

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Abstract
Outcomes from in-hospital resuscitation attempts are poor. Most patients the immediately and very few survive to go home. Hershey and Fisher (1) found that 14 per cent of the 88 patients in their study who suffered a cardiopulmonary arrest survived to go home, but only 3 per cent of those resuscitated on a general ward were discharged. These findings were confirmed by an investigation by Bedell et al(2). They found an initial success rate of 44 per cent, with only 14 per cent surviving to go home: attempts lasting longer than 15 minutes were associated with a 95 per cent mortality rate and intubation during resuscitation was associated with a 91 per cent rate. In the UK, Marsden (3) investigated 2,994 resuscitation attempts and found an immediate survival rate of 39 per cent, but only 16 per cent were still alive six months later and 11 per cent survived to one year. Burns et al (4) found an initial success rate of 46 per cent, but only 7 per cent of patients in their study survived to be discharged from hospital.

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