Receiving hospital characteristics associated with survival after out-of-hospital cardiac arrest
Survival after out-of-hospital cardiac arrest (OOHCA) varies between regions, but the contribution of different factors to this variability is unknown. This study examined whether survival to hospital discharge was related to receiving hospital characteristics, including bed number, capability of pe...
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Published in | Resuscitation Vol. 81; no. 5; pp. 524 - 529 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Shannon
Elsevier Ireland Ltd
01.05.2010
Elsevier |
Subjects | |
Online Access | Get full text |
ISSN | 0300-9572 1873-1570 1873-1570 |
DOI | 10.1016/j.resuscitation.2009.12.006 |
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Abstract | Survival after out-of-hospital cardiac arrest (OOHCA) varies between regions, but the contribution of different factors to this variability is unknown. This study examined whether survival to hospital discharge was related to receiving hospital characteristics, including bed number, capability of performing cardiac catheterization and hospital volume of OOHCA cases.
Prospective observational database of non-traumatic OOHCA assessed by emergency medical services was created in 8 US and 2 Canadian sites from December 1, 2005 to July 1, 2007. Subjects received hospital care after OOHCA, defined as either (1) arriving at hospital with pulses, or (2) arriving at hospital without pulses, but discharged or died ≥1 day later.
A total of 4087 OOHCA subjects were treated at 254 hospitals, and 32% survived to hospital discharge. A majority of subjects (68%) were treated at 116 (46%) hospitals capable of cardiac catheterization. Unadjusted survival to discharge was greater in hospitals performing cardiac catheterization (34% vs. 27%,
p
=
0.001), and in hospitals that received ≥40 patients/year compared to those that received <40 (37% vs. 30%,
p
=
0.01). Survival was not associated with hospital bed number, teaching status or trauma center designation. Length of stay (LOS) for surviving subjects was shorter at hospitals performing cardiac catheterization (
p
<
0.01). After adjusting for all variables, there were no independent associations between survival or LOS and hospital characteristics.
Some subsets of hospitals displayed higher survival and shorter LOS for OOHCA subjects but there was no independent association between hospital characteristics and outcome. |
---|---|
AbstractList | Survival after out-of-hospital cardiac arrest (OOHCA) varies between regions, but the contribution of different factors to this variability is unknown. This study examined whether survival to hospital discharge was related to receiving hospital characteristics, including bed number, capability of performing cardiac catheterization and hospital volume of OOHCA cases.AIMSurvival after out-of-hospital cardiac arrest (OOHCA) varies between regions, but the contribution of different factors to this variability is unknown. This study examined whether survival to hospital discharge was related to receiving hospital characteristics, including bed number, capability of performing cardiac catheterization and hospital volume of OOHCA cases.Prospective observational database of non-traumatic OOHCA assessed by emergency medical services was created in 8 US and 2 Canadian sites from December 1, 2005 to July 1, 2007. Subjects received hospital care after OOHCA, defined as either (1) arriving at hospital with pulses, or (2) arriving at hospital without pulses, but discharged or died > or =1 day later.MATERIAL AND METHODSProspective observational database of non-traumatic OOHCA assessed by emergency medical services was created in 8 US and 2 Canadian sites from December 1, 2005 to July 1, 2007. Subjects received hospital care after OOHCA, defined as either (1) arriving at hospital with pulses, or (2) arriving at hospital without pulses, but discharged or died > or =1 day later.A total of 4087 OOHCA subjects were treated at 254 hospitals, and 32% survived to hospital discharge. A majority of subjects (68%) were treated at 116 (46%) hospitals capable of cardiac catheterization. Unadjusted survival to discharge was greater in hospitals performing cardiac catheterization (34% vs. 27%, p=0.001), and in hospitals that received > or =40 patients/year compared to those that received <40 (37% vs. 30%, p=0.01). Survival was not associated with hospital bed number, teaching status or trauma center designation. Length of stay (LOS) for surviving subjects was shorter at hospitals performing cardiac catheterization (p<0.01). After adjusting for all variables, there were no independent associations between survival or LOS and hospital characteristics.RESULTSA total of 4087 OOHCA subjects were treated at 254 hospitals, and 32% survived to hospital discharge. A majority of subjects (68%) were treated at 116 (46%) hospitals capable of cardiac catheterization. Unadjusted survival to discharge was greater in hospitals performing cardiac catheterization (34% vs. 27%, p=0.001), and in hospitals that received > or =40 patients/year compared to those that received <40 (37% vs. 30%, p=0.01). Survival was not associated with hospital bed number, teaching status or trauma center designation. Length of stay (LOS) for surviving subjects was shorter at hospitals performing cardiac catheterization (p<0.01). After adjusting for all variables, there were no independent associations between survival or LOS and hospital characteristics.Some subsets of hospitals displayed higher survival and shorter LOS for OOHCA subjects but there was no independent association between hospital characteristics and outcome.CONCLUSIONSSome subsets of hospitals displayed higher survival and shorter LOS for OOHCA subjects but there was no independent association between hospital characteristics and outcome. Survival after out-of-hospital cardiac arrest (OOHCA) varies between regions, but the contribution of different factors to this variability is unknown. This study examined whether survival to hospital discharge was related to receiving hospital characteristics, including bed number, capability of performing cardiac catheterization and hospital volume of OOHCA cases. Prospective observational database of non-traumatic OOHCA assessed by emergency medical services was created in 8 US and 2 Canadian sites from December 1, 2005 to July 1, 2007. Subjects received hospital care after OOHCA, defined as either (1) arriving at hospital with pulses, or (2) arriving at hospital without pulses, but discharged or died ≥1 day later. A total of 4087 OOHCA subjects were treated at 254 hospitals, and 32% survived to hospital discharge. A majority of subjects (68%) were treated at 116 (46%) hospitals capable of cardiac catheterization. Unadjusted survival to discharge was greater in hospitals performing cardiac catheterization (34% vs. 27%, p = 0.001), and in hospitals that received ≥40 patients/year compared to those that received <40 (37% vs. 30%, p = 0.01). Survival was not associated with hospital bed number, teaching status or trauma center designation. Length of stay (LOS) for surviving subjects was shorter at hospitals performing cardiac catheterization ( p < 0.01). After adjusting for all variables, there were no independent associations between survival or LOS and hospital characteristics. Some subsets of hospitals displayed higher survival and shorter LOS for OOHCA subjects but there was no independent association between hospital characteristics and outcome. Abstract Aim Survival after out-of-hospital cardiac arrest (OOHCA) varies between regions, but the contribution of different factors to this variability is unknown. This study examined whether survival to hospital discharge was related to receiving hospital characteristics, including bed number, capability of performing cardiac catheterization and hospital volume of OOHCA cases. Material and methods Prospective observational database of non-traumatic OOHCA assessed by emergency medical services was created in 8 US and 2 Canadian sites from December 1, 2005 to July 1, 2007. Subjects received hospital care after OOHCA, defined as either (1) arriving at hospital with pulses, or (2) arriving at hospital without pulses, but discharged or died ≥1 day later. Results A total of 4087 OOHCA subjects were treated at 254 hospitals, and 32% survived to hospital discharge. A majority of subjects (68%) were treated at 116 (46%) hospitals capable of cardiac catheterization. Unadjusted survival to discharge was greater in hospitals performing cardiac catheterization (34% vs. 27%, p = 0.001), and in hospitals that received ≥40 patients/year compared to those that received <40 (37% vs. 30%, p = 0.01). Survival was not associated with hospital bed number, teaching status or trauma center designation. Length of stay (LOS) for surviving subjects was shorter at hospitals performing cardiac catheterization ( p < 0.01). After adjusting for all variables, there were no independent associations between survival or LOS and hospital characteristics. Conclusions Some subsets of hospitals displayed higher survival and shorter LOS for OOHCA subjects but there was no independent association between hospital characteristics and outcome. Survival after out-of-hospital cardiac arrest (OOHCA) varies between regions, but the contribution of different factors to this variability is unknown. This study examined whether survival to hospital discharge was related to receiving hospital characteristics, including bed number, capability of performing cardiac catheterization and hospital volume of OOHCA cases. Prospective observational database of non-traumatic OOHCA assessed by emergency medical services was created in 8 US and 2 Canadian sites from December 1, 2005 to July 1, 2007. Subjects received hospital care after OOHCA, defined as either (1) arriving at hospital with pulses, or (2) arriving at hospital without pulses, but discharged or died > or =1 day later. A total of 4087 OOHCA subjects were treated at 254 hospitals, and 32% survived to hospital discharge. A majority of subjects (68%) were treated at 116 (46%) hospitals capable of cardiac catheterization. Unadjusted survival to discharge was greater in hospitals performing cardiac catheterization (34% vs. 27%, p=0.001), and in hospitals that received > or =40 patients/year compared to those that received <40 (37% vs. 30%, p=0.01). Survival was not associated with hospital bed number, teaching status or trauma center designation. Length of stay (LOS) for surviving subjects was shorter at hospitals performing cardiac catheterization (p<0.01). After adjusting for all variables, there were no independent associations between survival or LOS and hospital characteristics. Some subsets of hospitals displayed higher survival and shorter LOS for OOHCA subjects but there was no independent association between hospital characteristics and outcome. |
Author | Rittenberger, Jon C. Callaway, Clifton W. Kampmeyer, Mitch Idris, Ahamed H. Rea, Tom D. Schmicker, Robert Nichol, Graham Daya, Mohamud R. Davis, Daniel P. Aufderheide, Thomas P. Powell, Judy |
AuthorAffiliation | 2 University of Washington, Seattle, WA 6 University of Texas, Southwestern Medical Center, Dallas, TX 5 University of California, San Diego, San Diego, CA 1 University of Pittsburgh, Pittsburgh, PA 3 Oregon Health and Science University, Portland, OR 4 Medical College of Wisconsin, Milwaukee, WI |
AuthorAffiliation_xml | – name: 1 University of Pittsburgh, Pittsburgh, PA – name: 5 University of California, San Diego, San Diego, CA – name: 2 University of Washington, Seattle, WA – name: 3 Oregon Health and Science University, Portland, OR – name: 4 Medical College of Wisconsin, Milwaukee, WI – name: 6 University of Texas, Southwestern Medical Center, Dallas, TX |
Author_xml | – sequence: 1 givenname: Clifton W. surname: Callaway fullname: Callaway, Clifton W. email: callawaycw@upmc.edu organization: University of Pittsburgh, Pittsburgh, PA, United States – sequence: 2 givenname: Robert surname: Schmicker fullname: Schmicker, Robert organization: University of Washington, Seattle, WA, United States – sequence: 3 givenname: Mitch surname: Kampmeyer fullname: Kampmeyer, Mitch organization: University of Pittsburgh, Pittsburgh, PA, United States – sequence: 4 givenname: Judy surname: Powell fullname: Powell, Judy organization: University of Washington, Seattle, WA, United States – sequence: 5 givenname: Tom D. surname: Rea fullname: Rea, Tom D. organization: University of Washington, Seattle, WA, United States – sequence: 6 givenname: Mohamud R. surname: Daya fullname: Daya, Mohamud R. organization: Oregon Health and Science University, Portland, OR, United States – sequence: 7 givenname: Thomas P. surname: Aufderheide fullname: Aufderheide, Thomas P. organization: Medical College of Wisconsin, Milwaukee, WI, United States – sequence: 8 givenname: Daniel P. surname: Davis fullname: Davis, Daniel P. organization: University of California, San Diego, San Diego, CA, United States – sequence: 9 givenname: Jon C. surname: Rittenberger fullname: Rittenberger, Jon C. organization: University of Pittsburgh, Pittsburgh, PA, United States – sequence: 10 givenname: Ahamed H. surname: Idris fullname: Idris, Ahamed H. organization: University of Texas, Southwestern Medical Center, Dallas, TX, United States – sequence: 11 givenname: Graham surname: Nichol fullname: Nichol, Graham organization: University of Washington, Seattle, WA, United States |
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Snippet | Survival after out-of-hospital cardiac arrest (OOHCA) varies between regions, but the contribution of different factors to this variability is unknown. This... Abstract Aim Survival after out-of-hospital cardiac arrest (OOHCA) varies between regions, but the contribution of different factors to this variability is... |
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SubjectTerms | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Canada Cardiac Catheterization Cardiopulmonary Resuscitation Catheterization Emergency Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Heart arrest Heart Arrest - mortality Heart Arrest - physiopathology Heart Arrest - therapy Hospital Bed Capacity - statistics & numerical data Humans Intensive care medicine Length of Stay - statistics & numerical data Medical sciences Patient Discharge Post-resuscitation care Prospective Studies Pulse Regionalization Registries Trauma Centers Treatment Outcome United States |
Title | Receiving hospital characteristics associated with survival after out-of-hospital cardiac arrest |
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