Predictors Associated with Survival Among Elderly In-Patients Who Receive Cardiopulmonary Resuscitation in Japan: An Observational Cohort Study.


BACKGROUND:Little is known about the outcomes of in-hospital cardiopulmonary resuscitation (CPR) in Asian populations including elderly patients in Japan. OBJECTIVE:To determine the survival outcome of in-hospital CPR among elderly patients in Japan, and to identify predictors associated with survival. DESIGN:Retrospective cohort study in 81 Japanese hospitals from April 1, 2010 to March 31, 2016. PATIENTS:We included elderly patients (age ≥ 65 years) who received CPR after 2 days of hospitalization. MAIN MEASURES:The primary outcome was survival at hospital discharge and the secondary outcomes were the discharge disposition and consciousness level of patients who survived to hospital discharge. To determine predictors associated with survival after in-hospital CPR, we fit multivariable models for patient-level and institutional-level factors. KEY RESULTS:Among the 5365 patients who received CPR, 595 (11%) survived to discharge. Of those who survived to discharge, 46% of patients were discharged home, and 10% of patients were comatose at discharge. Older age and higher burden of comorbidities were associated with reduced survival. The adjusted OR was 0.35 (95% CI, 0.22-0.55) for age ≥ 90 years compared to age 65-69 years, and 0.68 (95% CI, 0.48-0.97) for Charlson Comorbidity Index score of ≥ 4 compared with score of 0. Other predictors of reduced survival included receiving CPR on weekends compared to weekdays (AOR, 0.63; 95% CI, 0.51-0.77) and in small hospitals compared to large hospitals (AOR, 0.58; 95% CI, 0.40-0.83). CONCLUSIONS:Among elderly patients in Japan, the survival rate of in-hospital CPR was approximately one in ten, and less than half of these patients were discharged home. In addition to older age and higher illness burden, receiving CPR on weekends and/or in small hospitals were significant predictors of reduced survival. These findings should be considered in advanced care planning discussions with elderly patients to avoid subjecting patients to CPR that are likely futile.


J Gen Intern Med


Hayashi T,Matsushima M,Bito S,Kanazawa N,Inoue N,Luthe SK,Wee CC




Has Abstract


2019-02-01 00:00:00














  • Primary Care Practitioners' Barriers to and Experience of COVID-19 Epidemic Control in China: a Qualitative Study.

    abstract:BACKGROUND:The coronavirus disease 2019 (COVID-19) emerged in December 2019 and posed numerous challenges to China's health system. Almost 4 million primary care practitioners (PCPs) participated in controlling the outbreak. However, PCPs' barriers to and experience of the epidemic control remain unknown and are essent...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Xu Z,Ye Y,Wang Y,Qian Y,Pan J,Lu Y,Fang L

    更新日期:2020-11-01 00:00:00

  • Patients' perceptions of physicians' recommendations for comfort care differ by patient age and gender.

    abstract:OBJECTIVE:To determine patient characteristics associated with patient and proxy perceptions of physicians' recommendations for life-prolonging care versus comfort care, and with acceptance of such recommendations. DESIGN:Cross-sectional. SETTING:Five teaching hospitals in Denver, Colo. PATIENTS:We studied 239 hospi...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,多中心研究


    authors: Johnson MF,Lin M,Mangalik S,Murphy DJ,Kramer AM

    更新日期:2000-04-01 00:00:00

  • Dual use of veterans health administration and Indian Health Service: healthcare provider and patient perspectives.

    abstract:BACKGROUND:Many American Indian and Alaska Native veterans are eligible for healthcare from Veterans Health Administration (VHA) and from Indian Health Service (IHS). These organizations executed a Memorandum of Understanding in 2003 to share resources, but little was known about how they collaborated to deliver health...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Kramer BJ,Vivrette RL,Satter DE,Jouldjian S,McDonald LR

    更新日期:2009-06-01 00:00:00

  • Impact of Medical Scribes on Physician and Patient Satisfaction in Primary Care.

    abstract:BACKGROUND:Use of electronic health records (EHRs) is associated with physician stress and burnout. While emergency departments and subspecialists have used scribes to address this issue, little is known about the impact of scribes in academic primary care. OBJECTIVE:Assess the impact of a scribe on physician and pati...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Pozdnyakova A,Laiteerapong N,Volerman A,Feld LD,Wan W,Burnet DL,Lee WW

    更新日期:2018-07-01 00:00:00

  • Changes in Physical Health After Supported Housing: Results from the Collaborative Initiative to End Chronic Homelessness.

    abstract:BACKGROUND:The permanent supported housing model is known to improve housing outcomes, but there has been sparse research on the effects of supported housing on physical health. Various organizations including the National Academy of Sciences have called for research in this area. OBJECTIVE:This observational multi-si...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,多中心研究


    authors: Tsai J,Gelberg L,Rosenheck RA

    更新日期:2019-09-01 00:00:00

  • Racial differences in blood pressure control: potential explanatory factors.

    abstract:OBJECTIVE:The objective of the study was to identify potential explanatory factors for racial differences in blood pressure (BP) control. DESIGN:The design of the study was a cross-sectional study PATIENTS/PARTICIPANTS:The study included 608 patients with hypertension who were either African American (50%) or white (...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,多中心研究


    authors: Bosworth HB,Powers B,Grubber JM,Thorpe CT,Olsen MK,Orr M,Oddone EZ

    更新日期:2008-05-01 00:00:00

  • Primary Care Clinicians' Beliefs and Strategies for Managing Chronic Pain in an Era of a National Opioid Epidemic.

    abstract:BACKGROUND:Little is known about how primary care clinicians (PCCs) approach chronic pain management in the current climate of rapidly changing guidelines and the growing body of research about risks and benefits of opioid therapy. OBJECTIVE:To better understand PCCs' approaches to managing patients with chronic pain ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Militello LG,Hurley RW,Cook RL,Danielson EC,Diiulio J,Downs SM,Anders S,Harle CA

    更新日期:2020-12-01 00:00:00

  • Implementation Strategies for Frontline Healthcare Professionals: People, Process Mapping, and Problem Solving.

    abstract::Implementation science is focused on developing and evaluating methods to reduce gaps between research and practice. As healthcare organizations become increasingly accountable for equity, quality, and value, attention has been directed to identifying specific implementation strategies that can accelerate the adoption...

    journal_title:Journal of general internal medicine

    pub_type: 社论


    authors: Lu AD,Kaul B,Reichert J,Kilbourne AM,Sarmiento KF,Whooley MA

    更新日期:2020-09-11 00:00:00

  • Physicians' decisions about continuing or stopping colon cancer screening in the elderly: a qualitative study.

    abstract:BACKGROUND:Experts suggest an individualized approach to colon cancer screening to take into account variation in older adults' life expectancies and potential to benefit from screening. However, little is known about how physicians make decisions about colon cancer screening in adults age 75 and older. OBJECTIVE:To u...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Lewis CL,Griffith J,Pignone MP,Golin C

    更新日期:2009-07-01 00:00:00

  • Health Literacy and Shared Decision-making: Exploring the Relationship to Enable Meaningful Patient Engagement in Healthcare.

    abstract::Research into health literacy and shared decision-making has largely developed along parallel, but distinct lines over the past two decades. There is little evidence that the concepts and related practice have intersected except in the most functional way, for example, to simplify shared decision-making tools by impro...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Muscat DM,Shepherd HL,Nutbeam D,Trevena L,McCaffery KJ

    更新日期:2020-05-29 00:00:00

  • The LEAP Program: Quality Improvement Training to Address Team Readiness Gaps Identified by Implementation Science Findings.

    abstract:BACKGROUND:Integrating evidence-based innovations (EBIs) into sustained use is challenging; most implementations in health systems fail. Increasing frontline teams' quality improvement (QI) capability may increase the implementation readiness and success of EBI implementation. OBJECTIVES:Develop a QI training program ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Damschroder LJ,Yankey NR,Robinson CH,Freitag MB,Burns JA,Raffa SD,Lowery JC

    更新日期:2020-09-08 00:00:00

  • Persistent Severe Fixed Airways Obstruction in a High-Dosing E-cigarette User.

    abstract::Electronic Nicotine Delivery Systems (ENDS), commonly referred to as "e-cigs," were first introduced in the United States in 2007. Since then, their use has grown substantially, with the largest market among adolescents and young adults. ENDS are often perceived by the public as safe alternatives to traditional cigare...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Macedonia TV,Krefft SD,Rose CS

    更新日期:2020-01-01 00:00:00

  • An Electronic Adherence Measurement Intervention to Reduce Clinical Inertia in the Treatment of Uncontrolled Hypertension: The MATCH Cluster Randomized Clinical Trial.

    abstract:BACKGROUND:To appropriately manage uncontrolled hypertension, clinicians must decide whether blood pressure (BP) is above goal due to a need for additional medication or to medication nonadherence. Yet, clinicians are poor judges of adherence, and uncertainty about adherence may promote inertia with respect to medicati...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,随机对照试验


    authors: Kronish IM,Moise N,McGinn T,Quan Y,Chaplin W,Gallagher BD,Davidson KW

    更新日期:2016-11-01 00:00:00

  • Which advance directive do patients prefer?

    abstract::This study examined patient acceptance of two different advance directives. Outpatients completed the two directives and a 12-item acceptability questionnaire for each, and then stated their directive preferences. Of 128 patients enrolled, 97 (76%) responded. Overall, 47% of the respondents were satisfied with the Let...

    journal_title:Journal of general internal medicine

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Reinders M,Singer PA

    更新日期:1994-01-01 00:00:00

  • Effectiveness and Reach of the Primary Palliative Care for Emergency Medicine (PRIM-ER) Pilot Study: a Qualitative Analysis.

    abstract:BACKGROUND:Palliative care interventions in the ED capture high-risk patients at a time of crisis and can dramatically improve patient-centered outcomes. OBJECTIVE:To understand the facilitators that contributed to the success of the Primary Palliative Care for Emergency Medicine (PRIM-ER) quality improvement pilot in...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Chung FR,Turecamo S,Cuthel AM,Grudzen CR,PRIM-ER Investigators.

    更新日期:2020-10-27 00:00:00

  • Systematic errors in medical decision making: judgment limitations.

    abstract::Much of medical practice involves the exercise of such basic cognitive tasks as estimating probabilities and synthesizing information. Scientists studying cognitive processes have identified impediments to accurate performance on these tasks. Together the impediments foster "cognitive bias." Five factors that can detr...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,评审


    authors: Dawson NV,Arkes HR

    更新日期:1987-05-01 00:00:00

  • HIV risk screening in the primary care setting. Assessment of physicians skills.

    abstract:OBJECTIVE:To assess the content and extent of HIV risk assessment by primary care physicians across a diverse panel of patients with unidentified HIV risk behaviors. DESIGN:Standardized patient examination to assess primary care physicians' skills at identifying and managing HIV infection and overall clinical skills. ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Wenrich MD,Curtis JR,Carline JD,Paauw DS,Ramsey PG

    更新日期:1997-02-01 00:00:00

  • Physicians' reasons for failing to comply with computerized preventive care guidelines.

    abstract::The objective of this study was to assess reasons for physicians' noncompliance with computer-generated preventive care reminders. In an academic general internal medicine practice, a survey of physicians' reasons for noncompliance found that 55% of reminders were not complied with. Reasons included "not applicable" i...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Litzelman DK,Tierney WM

    更新日期:1996-08-01 00:00:00

  • The night float system of resident on call: what do the nurses think?

    abstract::In 1989, the internal medicine residency training program at St. John's Episcopal Hospital changed from a standard one-in-four on-call system to a night float system of resident on call. Using a confidential questionnaire that assessed the opinions of medical nurses, the nurses were asked which system they preferred, ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Buff DD,Shabti R

    更新日期:1995-07-01 00:00:00

  • The adoption of preventive care practice guidelines by primary care physicians: do actions match intentions?

    abstract:OBJECTIVE:To measure primary care physicians' familiarity with, attitudes toward, and confidence in preventive care practice guidelines for the elderly and to determine whether their attitudes are associated with implementation of guidelines into clinical practice. DESIGN:A self-administered survey of physicians emplo...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Weingarten S,Stone E,Hayward R,Tunis S,Pelter M,Huang H,Kristopaitis R

    更新日期:1995-03-01 00:00:00

  • Correction to: Vascular Ehlers-Danlos Syndrome Presenting as a Pulsatile Neck Mass: a Case Report and Review of Literature.

    abstract::This paper was inadvertently published with open access; the authors have requested the copyright revert to the society. It has been re-published with appropriate licensing. ...

    journal_title:Journal of general internal medicine

    pub_type: 已发布勘误


    authors: Maraj B,Harding-Theobald E,Karaki F

    更新日期:2018-12-01 00:00:00

  • The effect of resident involvement on community hospital charges.

    abstract::Attempts to explain the high cost of care in teaching hospitals have yielded conflicting results. This study was conducted to compare hospital charges and lengths of stay for two groups of patients: one cared for by a resident team and the other cared for by attending physicians. The study was conducted at a universit...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Dunn PM,Parker DF,Levinson W,Mullooly JP

    更新日期:1989-03-01 00:00:00

  • Correction to: Internal Medicine Point of Care Ultrasound: Indicators It's Here to Stay.

    abstract::This editorial, "Internal Medicine Point of Care Ultrasound: Indicators It's Here to Stay" (DOI: 10.1007/s11606-019-05268-0), was intended to accompany "Education Indicators for Internal Medicine Point-of-Care Ultrasound: a Consensus Report from the Canadian Internal Medicine Ultrasound (CIMUS) Group". ...

    journal_title:Journal of general internal medicine

    pub_type: 已发布勘误


    authors: Ambasta A,Balan M,Mayette M,Goffi A,Mulvagh S,Buchanan B,Montague S,Ruzycki S,Ma IWY,Canadian Internal Medicine Ultrasound (CIMUS) Group.,Ambasta A,Balan M,Blouw M,Buchanan B,Card SE,Chan B,Desy J,Demchuk G,Gebhardt C

    更新日期:2020-02-01 00:00:00

  • Development and Content Validation of a Patient-Reported Sexual Risk Measure for Use in Primary Care.

    abstract:BACKGROUND:Patient-provider sexual risk behavior discussions occur infrequently but may be facilitated by high-quality sexual risk screening tools. OBJECTIVE:To develop the Sexual Risk Behavior Inventory (SRBI), a brief computer-administered patient-reported measure. DESIGN:Qualitative item development/quantitative i...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,多中心研究


    authors: Fredericksen RJ,Mayer KH,Gibbons LE,Edwards TC,Yang FM,Walcott M,Brown S,Dant L,Loo S,Gutierrez C,Paez E,Fitzsimmons E,Wu AW,Mugavero MJ,Mathews WC,Lober WB,Kitahata MM,Patrick DL,Crane PK,Crane HM

    更新日期:2018-10-01 00:00:00

  • Measuring resident well-being: impostorism and burnout syndrome in residency.

    abstract:BACKGROUND:Assessing resident well-being is becoming increasingly important from a programmatic standpoint. Two measures that have been used to assess this are the Clance Impostor Scale (CIS) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). However, little is known about the relationship between the t...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Legassie J,Zibrowski EM,Goldszmidt MA

    更新日期:2008-07-01 00:00:00

  • Differences in leisure-time, household, and work-related physical activity by race, ethnicity, and education.

    abstract:BACKGROUND:Racial and ethnic minority groups have lower levels of leisure-time physical activity (LTPA) than whites, but it is unclear how much of this is explained by differences in socioeconomic status and health. OBJECTIVE:To examine differences in LTPA, work-related physical activity (WRPA; heavy household chores ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: He XZ,Baker DW

    更新日期:2005-03-01 00:00:00

  • Beliefs about asthma and complementary and alternative medicine in low-income inner-city African-American adults.

    abstract:BACKGROUND:The gap in asthma prevalence, morbidity, and mortality is increasing in low-income racial/ethnic minority groups as compared with Caucasians. In order to address these disparities,alternative beliefs and behaviors need to be identified. OBJECTIVE:To identify causal models of asthma and the context of conven...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: George M,Birck K,Hufford DJ,Jemmott LS,Weaver TE

    更新日期:2006-12-01 00:00:00

  • "Everything I know I learned from my mother...Or not": perspectives of African-American and white women on decisions about tubal sterilization.

    abstract:BACKGROUND:African-American women have had higher rates of female sterilization compared to white women since its emergence as a contraceptive method. The reasons underlying this observed racial difference are unknown. OBJECTIVES:The goals of this study were to (1) explore what factors shape black and white women's de...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Borrero S,Nikolajski C,Rodriguez KL,Creinin MD,Arnold RM,Ibrahim SA

    更新日期:2009-03-01 00:00:00

  • General medical and pharmacy claims expenditures in users of behavioral health services.

    abstract:OBJECTIVE:To quantify the magnitude of general medical and/or pharmacy claims expenditures for individuals who use behavioral health services and to assess future claims when behavioral service use persists. DESIGN:Retrospective cost trends and 24-month cohort analyses. SETTING:A Midwest health plan. PARTICIPANTS:Ov...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Kathol RG,McAlpine D,Kishi Y,Spies R,Meller W,Bernhardt T,Eisenberg S,Folkert K,Gold W

    更新日期:2005-02-01 00:00:00

  • Egocentric Health Networks and Cardiovascular Risk Factors in the ECHORN Cohort Study.

    abstract:BACKGROUND:Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the Caribbean region. OBJECTIVE:This study explored the concept of a health network, relationships focused on health-related matters, and examined associations with CVD risk factors in the Eastern Caribbean. DESIGN:The Eastern ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Oladele CR,Thompson TA,Wang K,Galusha D,Tran E,Martinez-Brockman JL,Adams OP,Maharaj RG,Nazario CM,Nunez M,Nunez-Smith M

    更新日期:2020-03-01 00:00:00