Cardiopulmonary resuscitation of adults in the hospital: A report of 14 720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation Mary Ann Peberdy *, William Kaye, Joseph P. Ornato, Gregory L. Larkin, Vinay Nadkarni, Mary Elizabeth Mancini, Robert A. Berg, Graham Nichol, Tanya Lane-Trultt, for the NRCPR Investigators Virginia Commonwealth University’s Health System, 401 North Broad Street, West Hospital, Room 1040, Box 980204, Richmond, VA 23298, USA Received 16 May 2003; accepted 12 June 2003 Abstract The National Registry of Cardiopulmonary Resuscitation (NRCPR) is an American Heart Association (AHA)-sponsored, prospective, multisite, observational study of in-hospital resuscitation. The NRCPR is currently the largest registry of its kind. The purpose of this article is to describe the NRCPR and to provide the first comprehensive, Utstein-based, standardized characterization of in-hospital resuscitation in the United States. All adult ( ]/18 years of age) and pediatric ( B/18 years of age) patients, visitors, employees, and staff within a facility (including ambulatory care areas) who experience a resuscitation event are eligible for inclusion in the NRCPR database. Between January 1, 2000, and June 30, 2002, 14 720 cardiac arrests that met inclusion criteria occurred in adults at the 207 participating hospitals. An organized emergency team is available 24 h a day, 7 days a week in 86% of participating institutions. The three most common reasons for cardiac arrest in adults were (1) cardiac arrhythmia, (2) acute respiratory insufficiency, and (3) hypotension. Overall, 44% of adult in-hospital cardiac arrest victims had a return of spontaneous circulation (ROSC); 17% survived to hospital discharge. Despite the fact that a primary arrhythmia was one of the precipitating events in nearly one half of adult cardiac arrests, ventricular fibrillation (VF) was the initial pulseless rhythm in only 16% of in- hospital cardiac arrest victims. ROSC occurred in 58% of VF cases, yielding a survival-to-hospital discharge rate of 34% in this subset of patients. An automated external defibrillator was used to provide initial defibrillation in only 1.4% of patients whose initial cardiac arrest rhythm was VF. Neurological outcome in discharged survivors was generally good. Eighty-six percent of patients with Cerebral Performance Category-1 (CPC-1) at the time of hospital admission had a postarrest CPC-1 at the time of hospital discharge. # 2003 Elsevier Ireland Ltd. All rights reserved. Keywords: Cardiopulmonary resuscitation; Cardiac arrest; Emergency treatment; Defibrillation Resumo O Registo Nacional de Reanimac ¸a ˜o Cardio-pulmonar (NRCPR) e ´ um estudo observacional de reanimac ¸a ˜o intrahospitalar multice ˆntrico, prospectivo, patrocinado pela American Heart Association (AHA). O NRCPR e ´ actualmente o maior registo do seu tipo. O objectivo deste artigo e ´ descrever o NRCPR e proporcionar a primeira caracterizac ¸a ˜o abrangente, baseada no modelo Utstein, da reanimac ¸a ˜o intrahospitalar nos Estados Unidos. Todos os doentes, visitantes, empregados e pessoal de uma instituic ¸a ˜o (incluindo a ´reas de cuidados ambulato ´rios), adultos (com idade igual ou superior a 18 anos) e pedia ´tricos (idade inferior a 18 anos), que tenham sido alvo de reanimac ¸a ˜o foram elegı ´veis para inclusa ˜o na base de dados NRCPR. Entre 1 de Janeiro de 2000 e 30 de * Corresponding author. Tel.:  /1-804-828-4571; fax:  /1-804-828-7710. E-mail address: mpeberdy@aol.com (M.A. Peberdy). Resuscitation 58 (2003) 297  /308 www.elsevier.com/locate/resuscitation 0300-9572/03/$ - see front matter # 2003 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/S0300-9572(03)00215-6