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Prevalence, predictors and outcomes of cardiopulmonary resuscitation in hospitalized adult stem cell transplant recipients in the United States: not just opening the black box but exploring an opportunity to optimize!

Bone Marrow Transplantation volume 50, pages 1578–1581 (2015)Cite this article

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In-hospital cardiac arrests (IHCA) requiring cardiopulmonary resuscitation (CPR) are common occurrences in the United States and worldwide.1, 2, 3, 4, 5, 6 In a large epidemiological study utilizing a nationwide sample in the United States, between the years 2000 and 2009, the rate of IHCA-CPR increased from 1 case per 453 to 1 case per 339 hospitalized patients.3 Although the overall survival to discharge rates have improved in the past decade, mortality rate remains high with fewer than 25% of CPR recipients surviving to discharge.2, 5 Comparatively, survival rates are much lower in patients with hematological malignancies, metastatic disease or in recipients of stem cell transplantation (SCT).7 CPR in SCT patients is thought to be a low yield intervention, occasionally labeled ‘heroic effort’ and often deemed futile. These perceptions are based on older data, smaller numbers and a few single-center experiences;7 and are not infrequently just anecdotal. Hospitalized SCT recipients are a unique population; and partly due to their immunosuppressive regimen, underlying medical condition necessitating SCT and/or associated comorbidity are at a higher risk of infection, multiorgan dysfunction and/or cardiac arrest compared with their hospitalized counterparts. However, current national estimates of CPR and associated outcomes in hospitalized SCT recipients are lacking.

SCT procedural volume and associated hospitalizations are increasing in the United States and worldwide.8, 9 It is imperative to identify and evaluate the risk factors associated with IHCA requiring CPR in this cohort so as to inform the patients, surrogates or providers involved in care and to optimize outcomes.

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Authors and Affiliations

  1. Division of Pediatric Critical Care, UH Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OH, USA

    N I Martinez-Schlurmann, D G Speicher, A T Rotta & V Allareddy

  2. Health Services Research & Policy, University of Nebraska Medical Center, Omaha, NE, USA

    S Rampa

  3. College of Dentistry, University of Iowa, Iowa City, IA, USA

    V Allareddy

Authors
  1. N I Martinez-Schlurmann
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  5. A T Rotta
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Correspondence to N I Martinez-Schlurmann.

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Limited results of the study were presented at 2015 Society of Critical Care Medicine, 44th Annual Congress, Phoenix, AZ, USA.

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Martinez-Schlurmann, N., Rampa, S., Speicher, D. et al. Prevalence, predictors and outcomes of cardiopulmonary resuscitation in hospitalized adult stem cell transplant recipients in the United States: not just opening the black box but exploring an opportunity to optimize!. Bone Marrow Transplant 50, 1578–1581 (2015). https://doi.org/10.1038/bmt.2015.183

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