Prognostic indicators of ultimate long-term survival following advanced life support

In an attempt to establish prognostic indicators for ultimate long-term survival following advanced life support (ALS), a two-year (1978-79) retrospective study was made of 92 survivors. The survivors were divided into two groups: the first survived admission to the intensive care unit, but subsequently died in the hospital; the second survived to ultimate discharge from the hospital. The groups were compared for sex, age, basic and advanced provider response time, scene an transport time, witnessed versus unwitnessed arrest, traumatic versus medical arrest, type of airway, presence of aspiration, initial cardiac rhythms, post-arrest vital signs, number of defibrillations, post-arrest ECG changes, essential and useful drugs used, and duration of basic and advanced life support. Of all prognostic indicators studied, duration of ALS correlated most closely with ultimate survival. This article advances the definition of ultimate survival of ALS to mean discharge of the patient from the hospital, and advocates this as the most objective evaluation of successful ALS. The article furthermore offers duration of ALS as an effective prognostic indicator of a patient's chance for ultimate survival.