Mathew C, Devan J, Jacob J. Cardiopulmonary resuscitation duration and patient survival in a South Indian intensive care unit. World J Crit Care Med 2025; 14(3): 105611 [DOI: 10.5492/wjccm.v14.i3.105611]
Corresponding Author of This Article
Christopher Mathew, Chief Physician, Senior Researcher, Department of Intensive Care, Aster Dr. Moopens Medical College Hospital, Christopher Mathew, Wayanad 673577, Kerala, India. drchristophermathew@gmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Sep 9, 2025; 14(3): 105611 Published online Sep 9, 2025. doi: 10.5492/wjccm.v14.i3.105611
Cardiopulmonary resuscitation duration and patient survival in a South Indian intensive care unit
Christopher Mathew, Jitha Devan, Jasmin Jacob
Christopher Mathew, Department of Intensive Care, Aster Dr. Moopens Medical College Hospital, Wayanad 673577, Kerala, India
Jitha Devan, Department of Internal Medicine, Dr. Moopens Medical College, Wayanad 673577, Kerala, India
Jasmin Jacob, Dentistry, Pearls Dental Clinic, Wayanad 673592, Kerala, India
Co-first authors: Christopher Mathew and Jitha Devan.
Author contributions: Mathew C, Devan J, Jacob J did the conceptualization, methodology, data curation and draft preparation: Mathew C did the supervison, validation, reviewing and editing.
Institutional review board statement: This study received approval from Department of Intensive Care Medicine, Dr. Moopens Medical College Hospital. Since it is an observational study, institutional ethics committee approval is waivered off.
Informed consent statement: Informed consent were obtained in accordance with institutional and ethical guidelines.
Conflict-of-interest statement: All authors declare that they have no competing interests.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Christopher Mathew, Chief Physician, Senior Researcher, Department of Intensive Care, Aster Dr. Moopens Medical College Hospital, Christopher Mathew, Wayanad 673577, Kerala, India. drchristophermathew@gmail.com
Received: January 30, 2025 Revised: April 9, 2025 Accepted: May 7, 2025 Published online: September 9, 2025 Processing time: 169 Days and 18.7 Hours
Abstract
BACKGROUND
Return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation (CPR) is a critical determinant of survival in patients experiencing cardiac arrest. This study aimed to investigate the relationship between the duration of CPR, the achievement of ROSC, and both short-term [intensive care unit (ICU) and in-hospital] and long-term survival outcomes in patients admitted to the medical intensive care unit (MICU) of Dr. Moopen’s Medical College Hospital, Wayanad, Kerala, India.
AIM
To assess how cardiopulmonary resuscitation duration impacts short-term and long-term survival in cardiac arrest patients in intensive care.
METHODS
A retrospective observational cohort study was conducted on adult patients who received CPR in the MICU between March 2023 and March 2024. Data were extracted from electronic medical records, including demographics, duration of CPR, ROSC achievement, and survival outcomes. Short-term survival was defined as survival to ICU discharge and in-hospital mortality, while long-term survival was assessed at six months post-arrest. Statistical analysis was performed using SPSS software, with Kaplan-Meier survival analysis and Cox regression used to identify predictors of mortality.
RESULTS
A total of 142 patients were included in the study. The median duration of CPR was 15 minutes. ROSC was achieved in 68 patients (47.9%). A significant association was observed between the duration of CPR and ROSC achievement (P < 0.001). Patients who achieved ROSC early had significantly higher rates of short-term and long-term survival compared to those who did not (P < 0.001). Each additional minute of CPR was associated with a 7% decrease in the odds of achieving ROSC. Longer CPR duration (HR: 1.05, 95%CI: 1.02-1.08), absence of ROSC (HR: 4.87, 95%CI: 2.31-10.28), older age (HR: 1.03, 95%CI: 1.01-1.06) and unwitnessed arrest (HR: 1.89, 95%CI: 1.05-3.41) were independent predictors of mortality.
CONCLUSION
Timely, effective cardiopulmonary resuscitation improves survival in intensive care. Duration significantly predicts return of circulation and outcomes. Further research should explore factors affecting resuscitation length and optimize treatment strategies.
Core Tip: This study investigated the association between cardiopulmonary resuscitation (CPR) duration and survival outcomes in critically ill patients admitted to a medical intensive care unit in South India. Longer CPR duration was significantly associated with lower rates of return of spontaneous circulation (ROSC) and decreased short-term and long-term survival. Each additional minute of CPR decreased the odds of achieving ROSC. These findings underscore the importance of timely and effective CPR in improving outcomes for critically ill patients.
