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Retrospective review on Charlson Comorbidity Index (CCI) as a predictor of return of spontaneous circulation (ROSC) and survival to discharge of geriatric in-hospital cardiopulmonary resuscitation (CPR) in a regional acute hospital in Hong Kong

conmed · 2026-01-20 · canonical JSON source

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Background and objectives This retrospective study was to investigate the impact of age, Charlson Comorbidity Index (CCI) and other premorbid/peri-arrest factors in predicting outcome of geriatric in-hospital cardiopulmonary resuscitation (CPR) in a regional acute hospital in Hong Kong.Method This study was conducted retrospectively on all inpatients aged 65 or above, who underwent CPR in acute medical and geriatric wards (excluding intensive care unit) in United Christian Hospital from January 2017 to December 2018. Patient demographics, comorbidities (as quantified by CCI) and CPR details were reviewed. Outcome was measured as sustained return of spontaneous circulation (ROSC) and survival at hospital discharge.Results 394 geriatric patients with a mean age of 82.06±8.11 years were included with median CCI of 4 (IQR: 3–6). 42.6% (n=168) of patients achieved sustained ROSC. Survival-to-discharge rate is 3.6% (14 patients). Age had no statistical associations with survival. Patients who survived to discharge had significantly lower CCI than those who deceased (median: 3, IQR: 2–4 vs median: 4, IQR: 3–6, p=0.017). Shockable rhythm (n=22) was significantly associated with survival to discharge (27.3% (n=6) versus 1.4% (5 out of 355), OR (95% CI): 26.250 (7.238 to 95.194) (p<0.001)). A better outcome of lower CCI persisted in the subgroup of patients with non-shockable rhythms. Postoperative status (n=20) (within 30 days) was a favourable factor for survival to discharge (20.0% (n=4) vs 2.2% (8 out of 366), OR (95% CI): 11.188 (3.047 to 41.072), p=0.002).Conclusion CCI showed usefulness in predicting inpatient CPR outcome in local geriatric patients. Age alone is not a prognostic indicator.