Abstract
Abstract 11679: Post-resuscitation Care and Survival After In-hospital Cardiac Arrest
Circulation (New York, N.Y.), Vol.134(Suppl_1 Suppl 1), pp.A11679-A11679
11/11/2016
DOI: 10.1161/circ.134.suppl_1.11679
Abstract
BackgroundMore than 40% of in-hospital cardiac arrest (IHCA) deaths occur in patients during the post-resuscitation period following return of spontaneous circulation (ROSC). However, the degree to which post-resuscitation survival varies across hospitals and whether this variation is explained by hospital characteristics is unknown.MethodsWe identified 80,201 patients within Get with the Guidelines-Resuscitation who achieved ROSC following IHCA. Using a multivariable hierarchical regression model, we calculated risk adjusted rates of post-resuscitation survival for each hospital and quantified hospital variation in post-resuscitation survival using median odds ratio (OR). We also assessed the association of hospital characteristics with post-resuscitation survival.ResultsThe mean age was 65.5 years, 57% were men, and 23% were black. Nearly 1 in 4 (23.0%) patients had an initial shockable rhythm. Overall, 33.5% of patients with ROSC survived to discharge, but the rate of post-resuscitation survival varied across hospitals (median hospital rate33.3%; interquartile range29.9%-36.7%; total range18.9%-55.1%). The median OR was 1.35 (95% CI1.30, 1.39, Figure), which suggests that post-resuscitation survival for 2 patients with similar covariates at 2 randomly selected hospitals varied by 35%. Except U.S. census region (P<0.001), no hospital characteristic was associated with hospital rates of post-resuscitation survival including, academic status, total bed number, hospital ownership, use of intensivists; number and proportion of intensive care unit [ICU] beds, neurological services, and coronary angiography capability.ConclusionsRates of post-resuscitation survival vary among U.S. hospitals. However, this variation is not explained by hospital structural characteristics, thus highlighting a pressing need to identify post-resuscitation best practices at top-performing hospitals in post-cardiac arrest care.
Details
- Title: Subtitle
- Abstract 11679: Post-resuscitation Care and Survival After In-hospital Cardiac Arrest
- Creators
- Saket Girotra - University of IowaBrahmajee NallamothuYunshu ZhouMary Vaughan-SarrazinPaul Chan
- Resource Type
- Abstract
- Publication Details
- Circulation (New York, N.Y.), Vol.134(Suppl_1 Suppl 1), pp.A11679-A11679
- Publisher
- by the American College of Cardiology Foundation and the American Heart Association, Inc
- DOI
- 10.1161/circ.134.suppl_1.11679
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Language
- English
- Date published
- 11/11/2016
- Academic Unit
- Cardiovascular Medicine; General Internal Medicine; Internal Medicine; Health Management and Policy
- Record Identifier
- 9984363429902771
Metrics
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