学术急诊医学档案

卷 14 编号 1 (2026)

Resuscitation Success and Survival to Hospital Discharge Following In-Hospital Cardiopulmonary Resuscitation in Iran: A Systematic Review and Meta-Analysis

学术急诊医学档案, 卷 14 编号 1 (2026), 1 十月 2025 , 第 e38 页
https://doi.org/10.22037/aaem.v14i1.3036

摘要

Introduction: Cardiopulmonary Resuscitation (CPR) is a critical emergency procedure that needs to be promptly administered to prevent irreversible damage and enhance the chances of survival. This systematic review and meta-analysis aimed to determine the success rate of CPR and the rate of survival to hospital discharge among patients who underwent CPR in hospitals throughout Iran.

Methods: This study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, and the protocol was registered in International Prospective Register of Systematic Reviews (PROSPERO) (CRD420251185276). A comprehensive search was conducted without time restriction until July 2026 in PubMed, Scopus, Web of Science, Google Scholar, SID, and Magiran databases. A random-effects model was used for meta-analysis, and heterogeneity was assessed using the I² index. Publication bias was evaluated using Begg’s test. Data analysis was performed using STATA software (version 14).

Results: Initially, 903 records were identified, and after removing duplicates and applying screening procedures, 47 studies met the inclusion criteria. The pooled analysis revealed that the rates of successful CPR, survival to discharge among successful CPR cases, and survival to discharge among all CPR attempts were 29.48% (95% confidence interval (CI): 25.04–33.92), 32.11% (95% CI: 24.00–40.21; I²=95.7%), and 8.63% (95% CI: 6.72–10.53), respectively. Meta-regression indicated an increasing trend over time for successful CPR, a decreasing trend for survival to discharge among cases with Return of Spontaneous Circulation (ROSC), and a significant increase in overall survival to discharge.

Conclusion: This systematic review highlights that while the initial quality of CPR in Iran is generally satisfactory, there is a notable gap between successful resuscitation and survival to hospital discharge, primarily attributed to limitations in post-resuscitation care. Enhancing post-CPR management, expanding ICU capacity, improving team coordination, and standardizing equipment could significantly impact patient outcomes.

关键词:
  • Cardiopulmonary resuscitation
  • Survival rate
  • Patient discharge
  • Meta-analysis
  • Systematic review
  • Iran

参考

1. Abdelazeem B, Awad AK, Manasrah N, Elbadawy MA, Ahmad S, Savarapu P, et al. The effect of vasopressin and methylprednisolone on return of spontaneous circulation in patients with in-hospital cardiac arrest: A systematic review and meta-analysis of randomized controlled trials. American Journal of Cardiovascular Drugs. 2022;22(5):523-33.

2. Randjelovic S, Nikolovski S, Selakovic D, Sreckovic M, Rosic S, Rosic G, et al. Time Is Life: Golden Ten Minutes on Scene–EuReCa_Serbia 2014–2023. Medicina. 2024;60(4):624.

3. Kane A, Nolan JP. Changes to the European Resuscitation Council guidelines for adult resuscitation. BJA education. 2022;22(7):265-72.

4. Yan S, Gan Y, Jiang N, Wang R, Chen Y, Luo Z, et al. The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis. Critical care. 2020;24(1):61.

5. Zhou G, Wang Y, Sun Z, Yuan M, Ma Y, Wu Q, et al. Survival outcome among patients with out-of-hospital cardiac arrest who received cardiopulmonary resuscitation in China: a systematic review and meta-analysis. European journal of medical research. 2023;28(1):8.

6. Nolan J, Ornato J, Parr M, Perkins G, Soar J. Resuscitation highlights in 2021. Resuscitation. 2022;172:64-73.

7. Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics—2020 update: a report from the American Heart Association. Circulation. 2020;141(9):e139-e596.

8. Andersen LW, Berg KM, Saindon BZ, Massaro JM, Raymond TT, Berg RA, et al. Time to epinephrine and survival after pediatric in-hospital cardiac arrest. Jama. 2015;314(8):802-10.

9. Hajizadeh R, Ghaffari S, Habibzadeh A, Safaei N, Mohammadi K, Ranjbar A, et al. Outcome of surgical embolectomy in patients with massive pulmonary embolism with and without cardiopulmonary resuscitation. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2017;14(4):241-4.

10. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS medicine. 2009;6(7):e1000097.

11. Downes MJ, Brennan ML, Williams HC, Dean RS. Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ open. 2016;6(12):e011458.

12. Orlewski J, Orlewska E. Effects of genetic polymorphisms of glutathione S-transferase genes (GSTM1, GSTT1, GSTP1) on the risk of diabetic nephropathy: a meta-analysis. Pol Arch Med Wewn. 2015;125(9):649-58.

13. Goodarzi A, Abdi A, Ghasemi H, Darvishi N, Jalali R. The outcomes of cardiopulmonary resuscitation and their predictors during the coronavirus 2019 pandemic in Iran. BMC emergency medicine. 2023;23(1):94.

14. Goodarzi A, Jalali A, Almasi A, Naderipour A, Kalhorii RP, Khodadadi A. Study of survival rate after cardiopulmonary resuscitation (CPR) in hospitals of Kermanshah in 2013. Global journal of health science. 2014;7(1):52-8.

15. Bolandparvaz SH, Mirzaee M, Abbasi HR, Amini A. CPCR results in cardiac arrested patients in Nemazee Hospital, Iran. Iranian Red Crescent medical journal. 2008;10(2):118-21.

16. Ezzati E, Mohammadi S, Karimpour H, Saman JA, Goodarzi A, Jalali A, et al. Assessing the effect of arrival time of physician and cardiopulmonary resuscitation (CPR) team on the outcome of CPR. Interventional medicine & applied science. 2020;11(3):139-45.

17. Alizadeh M, Movahed MM, Sadredini S, Mostafav A, Fathi M. The evaluation of the resuscitation results and its associated factors. Tehran University Medical Journal. 2016;74(9):640-4.

18. Assar S, Hossienzadeh M, Nikravesh AH, Davoodzadeh H. The Success Rate of Pediatric In-Hospital Cardiopulmonary Resuscitation in Ahvaz Training Hospitals. Scientifica. 2016;2016(1):9648140..

19. Nazarpour P, Jafaraghaei F, Moghadamnia MT, Maroufizadeh S. Predictors of Long-term Survival After Cardiopulmonary Resuscitation. Journal of Holistic Nursing and Midwifery. 2022;32(2):124-34.

20. Mehdizadeh H, Bahari Z, Zekriamir S, Shahriary H, Behzadnia MJ. The Aassociation between Pre-Cardiac Arrest Comorbidity and Unsuccessful Cardiopulmonary Resuscitation in Patients with Cardiac Arrest. Journal of Advances in Medical and Biomedical Research. 2023;31(144):40-5.

21. Hajbaghery MA, Mousavi G, Akbari H. Factors influencing survival after in-hospital cardiopulmonary resuscitation. Resuscitation. 2005;66(3):317-21.

22. Bolvardi E, Pouryaghobi SM, Farzaneh R, Chokan NMJ, Ahmadi K, Reihani H. The prognostic value of using ultrasonography in cardiac resuscitation of patients with cardiac arrest. International Journal of Biomedical Science. 2016;12(3):110-4.

23. Masoumi B, Azizkhani R, Heydari F, Zamani M, Nasr Isfahani MN. The Role of Cardiac Arrest Sonographic Exam (CASE) in Predicting the Outcome of Cardiopulmonary Resuscitation; a Cross-sectional Study. Archives of academic emergency medicine. 2021;9(1).

24. Seyedhosseini J, Ahmadi R, Karimialavijeh E, Aghili M. Relationship between cardiac ultrasound findings during cardiopulmonary resuscitation with the outcome of patients. Journal of Emergency Practice and Trauma. 2023;9(1):32-7.

25. Mansouri M, Massoumi G, Emami SA, Mahmoudi F, Shokrani A. Evaluation of the performance of cardiopulmonary resuscitation (CPR) team, shahid chamran hospital, Isfahan, Iran, in 2015. Journal of Isfahan Medical School. 2017;35(426):406-11.

26. Montazer SH, Amooei M, Sheyoei M, Bahari M. Results of CPR and contributing factor in emergency department of Sari Imam Khomeini hospital, 2011-2013. Journal of Mazandaran University of Medical Sciences.2014; 24(111):53.

27. Norozi S, Poursiabidi P. Examining the results of cardiopulmonary resuscitation and its influencing factors with emphasis on the cause of cardiac arrest and 1-year prognosis of rescued patients. Tehran University Medical Journal.2023;80(12).957-964.

28. Chan PS, Spertus JA, Kennedy K, Nallamothu BK, Starks MA, Girotra S, et al. In-hospital cardiac arrest survival in the United States during and after the initial novel coronavirus disease 2019 pandemic surge. Circulation: Cardiovascular Quality and Outcomes. 2022;15(2):e008420.

29. Bielski K, Makowska K, Makowski A, Kopiec T, Gasecka A, Malecka M, et al. Impact of COVID-19 on in-hospital cardiac arrest outcomes: An updated meta-analysis. Cardiology Journal. 2021;28(6):816-24.

30. Marijon E, Karam N, Jost D, Perrot D, Frattini B, Derkenne C, et al. Out-of-hospital cardiac arrest during the COVID-19 pandemic in Paris, France: a population-based, observational study. The Lancet Public Health. 2020;5(8):e437-e43.

31. Goodarzi A, Khodaveisi M, Abdi A, Salimi R, Oshvandi K. Cardiopulmonary Resuscitation Outcomes of Patients with COVID-19; a One-Year Survey. Archives of academic emergency medicine. 2021;9(1):e70.

32. Bolandparvaz SH, Mohammadzadeh A, Amini A, Abbasi HR, Ahmadi MM, Ghaffaripour S. Cardiopulmonary Arrest Outcome in Nemazee Hospital, Southern Iran. Iranian Red Crescent medical journal. 2009;11(4):437-41.

33. Ghasemzadeh G, Soodmand M, Moghadamnia MT. The Cardiac Risk Factors of Coronary Artery Disease and its relationship with Cardiopulmonary resuscitation: A retrospective study. The Egyptian Heart Journal. 2018;70(4):389-92.

34. Gharib B, Memarian S. The Effect of the Time of In-hospital Cardiopulmonary Resuscitation on the Immediate Outcome in Pediatric Patients. Journal of Iranian Medical Council. 2024;7(2):279-86.

35. Safari S, Safdarian A, Yousefifard M, Aghili SH, Ranjbar MF. Predictive factors of spontaneous circulation return following in-hospital cardiac arrest: a cross-sectional study. Frontiers in Emergency Medicine.2025;9(1).

36. Rahsepar NS, Shirzadi R, Zagheh YM, Akrami R, Memar EHE. Survival Measures After Cardiopulmonary Resuscitation and Related Factors Among Children: Retrospective Cohort Study in Iran. International cardiovascular research journal. 2025;19(1).

37. Rafati H, Saghafi A, Saghafinia M, Panahi F, Hoseinpour M. Survival after in-hospital cardiopulmonary resuscitation in a major referral center during 2001-2008. Iranian Journal of Medical Sciences. 2011;36(1):50-3.

38. Heydari F, Nasr Isfahani M, Masoumi B, Khajebashi SH, Hajian F, Soleimani F. The role of serial point-of-care ultrasound during cardiac arrest to predict termination of resuscitation. Scandinavian journal of trauma, resuscitation and emergency medicine. 2025;33(1):129.

39. Mir Mohammad Sadeghi P, Mirmohammad-Sadeghi M. Cardiopulmonary arrest after cardiac surgery: A retrospective cohort of 142 patients with nine year follow up. Heart and Lung. 2021;50(3):382-5.

40. Ziapour A, Hatami Garosi V, Tamri Y, Ghazvineh S, Azizi A. Investigating the outcomes of cardiopulmonary resuscitation and factors affecting it: A cross-sectional study at Dr. Moaven Hospital, Sahneh City from 2014 to 2021. Health Science Reports. 2023;6.(8).

41. Jaberi Y, Changizian L, Mazloomzadeh S. Predictors of outcome in in-hospital cardio-pulmonary resuscitation. Journal of Zanjan University of Medical Sciences and Health Services. 2011;19.(75).

42. Omidi A, Haghshenas A, Tayebi N, Radmanmehr M, Askaryzadeh Mahani MAZ, Abadi NE. Assessment of the results of cardiopulmonary resuscitation and its effective factors in pastor bam hospital. International Journal of Pharmaceutical Research. 2018;10(1):257-63.

43. Nazri Panjaki A, Salari N, Khoshfetrat M. Investigating the Success Rate of Cardiopulmonary Resuscitation, Survival Rate in Patients,and their Related Factor . J Critical Care Nursing. 2018;11(1):1-5.

44. Taghi Moghadamnia M, Borghei Y, Amini S, Maroufizadeh S. The Cardiopulmonary Resuscitation Success Rate and Its Related Factors in Patients Referred to Dr. Heshmat Hospital in Rasht, Iran .J Journal of Guilan University of Medical Sciences. 2022;31(1):62-73.

45. Farzaneh E, Amani F, Mohammadian LJIJRMS. The success rate of CPR and its related factors in the emergency department of Ardabil Imam Khomeini hospital, 2013. 2015;3:602-5

46. Arhami Dolatabadi A, Memari E, Shojaee M, Alimohammadi H, Kariman H, Shahrami A, et al. Survival and outcomes following cardiopulmonary resuscitation; a descriptive study in Iran .J Journal of Emergency Practice and Trauma. 2017;3(1):22-5

47. Tavakolian A, Saeidi R, Foroughian M, Mirjalili SM, Shayeghi Rad M. Success Rate of Cardiopulmonary Resuscitation and Related Factors in Emergency Department of a Private Hospital in Mashhad . J Razavi Journal of Medicine. 2021;9(2):6-8.

48. Saghafinia M, Motamedi MHK, Piryaie M, Rafati H, Saghafi A, Jalali A, et al. Survival after in-hospital cardiopulmonary resuscitation in a major referral center. 2010;4(2):68-71.

49. NEKOOFARD M, SHAHROKHI DS, Abdolmaleki P, VENDAEI O, GHASEMI M, DOOSTI M. Success rate of cardiopulmonary resuscitation in the intensive care unit of an Iran’s Army Air Force hospital in 2012. Ann Mil Health Sci Res. 2014;12(3):e63286.

50. Hajzargarbashi E, Omidi E, Esmailian M. Correlation of Patients' Baseline Characteristics with Success Rate of Cardiopulmonary Resuscitation; a Cross-Sectional Study. Advanced journal of emergency medicine. 2019;3(1):e6.

51. Moezzi M, Afshari G, Rahim F, Alavian M, Banitorfi M, Hesam S, et al. Outcomes of cardiopulmonary resuscitation and its predictors in hospitalized patients. Clin Med Rev Case Rep.2020; 7:309.

52. Azimi B, Motaghi M. The Study of the success of CPR team in Besat Health & Care hospital in Hamedan in the first six months of 2009 .J Journal of Rescue Relief. 2010;2(2).

53. Nasiripour A, Masoudi Asl I, Fathi E. The relationship of CPR success and time of patients’ referring to emergency department. 2012;14(1):21-5.

54. Salari A, Mohammadnejad E, Vanaki Z, Ahmadi F. Survival rate and outcomes of cardiopulmonary resuscitation. 2010;3(2):45-9.

55. Sadeghi E, Bahmani H, Khorshidi S. The Status of Cardio-Pulmonary Resuscitation (CPR) and the Related Factors Thereof in Shahid Motahari Hospital of Marvdasht A Descriptive Cross-Sectional Study .J Pars Journal of Medical Sciences. 2022;18(1):23-8.

56. Dabbagh A , Fathi M , Kasraei F , Razavi SS Short term survival after cardiopulmonary resuscitation in emergency departments of two hospitals in Tehran, Iran (2005) .J Journal of Gorgan University of Medical Sciences. 2010;12(2):58-62.

57. Abrishami S, Bavarian B, Khodaei S. Success Rate of CPR and the Effective factors. IRANIAN JOURNAL OF PEDIATRICS . 2006;16(4):481-484.

58. Barzigar A, Ahmadnia Z, Salari A, Kheirkhah J, Naghavi SM. Cardiopulmonary Resuscitation Success Rates and Demographic, Clinical and Diagnostic Characteristics of Patients Undergoing Cardiopulmonary Resuscitation .J Jundishapur Scientific Medical Journal. 2024;23(3):264-72.

59. HOMAYOUNFAR S, AZAR BZ. The study of in hospital prognosis of 101 patients who admitted in coronary care unit and resuscitated after cardiac arrest. Avicenna J Clin Med. 2002; 8 (4).

60. Keivanpazhoh k, Rahimi Rad mh, Farrokh Islamlo h. QUALITY AND OUTCOME OF CARDIOPULMONARY RESUSCITATION IN IMAM KHOMEINI TEACHING HOSPITAL- REPORT ACCORDING TO UTSTEIN STYLE .J Studies in Medical Sciences. 2011;22(4):346-52.

61. Ahmed MAM, Memarian S, Malekzadeh I, Ghahvechi-Akbari M, Gharib B. The Outcome and Hospital Discharge Rate after Pediatric in Hospital CPR During Nights and Weekends. J Iran Med Counc. 2025;8(1):154-60.

62. Ojaghi Haghighi SH, Shams Vahdati S, Mahmoudie T, Sepehri Majd P, Mirza-Aghazadeh-Attari M. Outcomes of cardiopulmonary resuscitation in the emergency department . J Journal of Emergency Practice and Trauma. 2017;3(2):49-52.

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