Research and Scholarship

Short- and Long-Term Outcomes of Hematologic Malignancy Patients After Cardiopulmonary Resuscitation: Experience of a Large Oncology Center

Mary Lou Warren, DNP, APRN, CNS-CC, FCCM, Virginia V. Schneider, MPAS, PA-C, Yun Qing, MHS, PhD, Lei Feng, MS, Jeanne Y. Campbell, MPAS, PA-C, Jason W. Myers, ACNP-BC, Marian Von-Maszewski, MD, and Cristina Gutierrez, MD

From The University of Texas MD Anderson Cancer Center, Houston, Texas

Authors’ disclosures of conflicts of interest are found at the end of this article.

Correspondence to: Mary Lou Warren, DNP, APRN, CNS-CC, FCCM, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030. E-mail: mlwarren@mdanderson.org.


J Adv Pract Oncol 2021;12(7):705–714 | https://doi.org/10.6004/jadpro.2021.12.7.4 | © 2021 Harborside™


  

ABSTRACT

Purpose: The objective of this study is to describe characteristics and short- and long-term outcomes of patients with hematologic malignancies who received cardiopulmonary resuscitation (CPR). Methods: A retrospective review was conducted of all Code Blues at a large comprehensive cancer center. Demographic, clinical, and outcome variables were analyzed for patients with a hematologic malignancy who underwent CPR. Results: Of 258 patients, 60.1% had leukemia. Outcomes included return of spontaneous circulation (70.2%), hospital survival (12%), and 90-day, 6-month, and 1-year survival rates of 9.8%, 8.2%, and 5.9%, respectively. Factors associated with hospital mortality included establishing a do not resuscitate order after CPR (p < .0001), location of CPR (p = .0004), cause of arrest (p = .0019), requiring vasopressors (p = .0130), mechanical ventilation (p = .0423), and acute renal failure post CPR (p = .0006). Although no difference in hospital survival between leukemia and non-leukemia patients was found, more non-leukemia patients were alive at 90 days (p = .0099), 6 months (p = .0023), and 1 year (p = .0119). Conclusions: Factors including organ dysfunction, location of CPR, and cause of arrest are associated with hospital mortality post CPR. However, immediate survival post CPR does not seem to be affected by a diagnosis of leukemia. These data should assist health care providers with discussions regarding advance care planning and goals of care after cardiac arrest. 




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