Clinical paperReceiving hospital characteristics associated with survival after out-of-hospital cardiac arrest☆,☆☆
Section snippets
Methods
Data were obtained from the ROC Cardiac Arrest Epidemiological Registry or “Epistry” which has been described in detail previously.12 This registry is a prospective database of all persons evaluated for OOHCA by participating EMS agencies. Over 250 EMS agencies at sites in Canada and the US contribute data on an ongoing basis. Multiple mechanisms for surveillance are used at local sites to assure investigators of capture of all appropriate cases. Data are abstracted from EMS records and
Results
Complete data were available from 8 sites in the US and 2 in Canada. EMS agencies delivered subjects to a total of 254 hospitals (144 in US and 110 in Canada). The distribution of hospital sizes was similar in the US and Canada (Table 1). A larger proportion of US hospitals performed cardiac catheterization and maintained residency programs than Canadian hospitals (Table 1). About 55% of hospitals reported being able to perform cardiac catheterization. Similar proportions of hospitals were
Discussion
After resuscitation by EMS or in the ED after OOHCA, the unadjusted probability of survival to discharge is associated with care at a hospital capable of cardiac catheterization or treating ≥40 OOHCA patients annually. Mean length of stay is also shorter for patients hospitalized at hospitals capable of cardiac catheterization. The characteristics of patients delivered to different categories of hospitals do not differ, but after adjusting for response and patient characteristics, there was no
Conflict of interest
The authors do not have any direct conflicts of interest related to the topics in this paper.
Acknowledgements
Funding sources: The ROC is supported by a series of cooperative agreements to 10 regional clinical centers and one Data Coordinating Center (5U01 HL077863, HL077881, HL077871 HL077872, HL077866, HL077908, HL077867, HL077885, HL077887, HL077873, HL077865) from the National Heart, Lung and Blood Institute in partnership with the National Institute of Neurological Disorders and Stroke, U.S. Army Medical Research & Material Command, The Canadian Institutes of Health Research (CIHR)—Institute of
References (37)
- et al.
Resuscitation Outcomes Consortium Investigators. Regional variation in out-of-hospital cardiac arrest incidence and outcome
JAMA
(2008) Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest
N Engl J Med
(2002)- et al.
Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia
N Engl J Med
(2002) - et al.
Implementation of a standardised treatment protocol for post resuscitation care after out-of-hospital cardiac arrest
Resuscitation
(2007) - et al.
Outcomes of a hospital-wide plan to improve care of comatose survivors of cardiac arrest
Resuscitation
(2008) - et al.
Inter-hospital variability in post-cardiac arrest mortality
Resuscitation
(2009) - et al.
In-hospital factors associated with improved outcome after out-of-hospital cardiac arrest. A comparison between four regions in Norway
Resuscitation
(2003) - et al.
A multiple logistic regression analysis of in-hospital factors related to survival at six months in patients resuscitated from out-of-hospital ventricular fibrillation
Resuscitation
(2003) - et al.
Hospital variability of out-of-hospital cardiac arrest survival
Prehosp Emerg Care
(2008) - et al.
Outcome in transferred and nontransferred patients after percutaneous coronary intervention for ischaemic out-of-hospital cardiac arrest
Cathet Cardiovasc Interv
(2008)
Six-month outcome of emergency percutaneous coronary intervention in resuscitated patients after cardiac arrest complicating ST-elevation myocardial infarction
Circulation
Rationale, development and implementation of the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest
Resuscitation
A descriptive analysis of Emergency Medical Service Systems participating in the Resuscitation Outcomes Consortium (ROC) network
Prehosp Emerg Care
Variability in survival after in-hospital cardiac arrest depending on the hospital level of care
Resuscitation
An evaluation of post-resuscitation care as a possible explanation of a difference in survival after out-of-hospital cardiac arrest
Resuscitation
Immediate coronary angiography in survivors of out-of-hospital cardiac arrest
N Engl J Med
Coronary angiography predicts improved outcome following cardiac arrest: propensity-adjusted analysis
J Intens Care Med
2007, Focused Update of the ACC/AHA 2004 Guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: developed in collaboration With the Canadian Cardiovascular Society endorsed by the American Academy of Family Physicians: 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction, Writing on Behalf of the 2004 Writing Committee
Circulation
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A Spanish translated version of the abstract of this article appears as Appendix in the online version at doi:10.1016/j.resuscitation.2009.12.006.