Interhospital variability in Out-of-Hospital cardiac arrest survival in a large metropolitan area

Pavitra Kotini-Shah; Nicole Blum; Shaveta Khosla; Joseph Weber; Eddie Markul; Katie Tataris; Teri Campbell; Terry Vanden Hoek; Marina Del Rios

doi:10.1016/j.resplu.2023.100385

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Interhospital variability in Out-of-Hospital cardiac arrest survival in a large metropolitan area

Journal article

Open access

Peer reviewed

Interhospital variability in Out-of-Hospital cardiac arrest survival in a large metropolitan area

Pavitra Kotini-Shah, Nicole Blum, Shaveta Khosla, Joseph Weber, Eddie Markul, Katie Tataris, Teri Campbell, Terry Vanden Hoek and Marina Del Rios

Resuscitation plus, Vol.14, 100385

06/2023

DOI: 10.1016/j.resplu.2023.100385

PMCID: PMC10090648

PMID: 37065731

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Abstract

Out-of-hospital cardiac arrest (OHCA) survival varies widely across the United States. The impact of hospital OHCA volume and ST-elevation myocardial infarction (STEMI) Receiving Center (SRC) designation on survival is not fully understood. This was a retrospective analysis of adult OHCA who survived to hospital admission reported to the Chicago Cardiac Arrest Registry to Enhance Survival (CARES) database from May 1, 2013 to December 31, 2019. Hierarchical logistic regression models were generated and adjusted by hospital characteristics. Survival to hospital discharge (SHD) and cerebral performance category (CPC) 1–2 at each hospital were calculated after adjusting for arrest characteristics. Hospitals were assigned quartiles (Q1-Q4) based on total arrest volume to allow for comparison of SHD and CPC 1–2 between quartiles. 4,020 patients met inclusion criteria. 21 of the 33 Chicago hospitals included in this study were designated SRCs. Adjusted SHD and CPC 1–2 rates ranged from 27.3% to 37.0% and from 8.9% to 25.1%, respectively, by hospital. SRC designation did not significantly affect SHD (OR 0.96; 95% CI, 0.71–1.30) nor CPC 1–2 (OR 1.17; 95% CI, 0.74–1.84). OHCA volume quartiles did not significantly affect SHD (Q2: OR 0.94; 95% CI, 0.54–1.60; Q3: OR 1.30; 95% CI, 0.78–2.16; Q4: OR 1.25; 95% CI, 0.74–2.10) nor CPC 1–2 (Q2: OR 0.75; 95% CI, 0.36–1.54; Q3: OR 0.94; 95% CI, 0.48–1.87; Q4: OR 0.97; 95% CI, 0.48–1.97). Interhospital variability in both SHD and CPC 1–2 cannot be explained by hospital arrest volume nor SRC status. Further research is warranted to explore reasons for interhospital variability.

Interhospital variability

Neurologic outcomes

Out of Hospital Cardiac Arrest

Survival

Details

Title: Subtitle: Interhospital variability in Out-of-Hospital cardiac arrest survival in a large metropolitan area
Creators: Pavitra Kotini-Shah - University of Illinois Chicago
Nicole Blum - University of Chicago
Shaveta Khosla - University of Illinois Chicago
Joseph Weber - Department of Emergency Medicine, John H. Stroger, Jr. Hospital, Chicago, IL, USA
Eddie Markul - Illinois Masonic Medical Center, Chicago, IL, USA
Katie Tataris - University of Chicago
Teri Campbell - University of Illinois Chicago
Terry Vanden Hoek - University of Illinois Chicago
Marina Del Rios - Department of Emergency Medicine, University of Iowa, Iowa City, IA, USA
Resource Type: Journal article
Publication Details: Resuscitation plus, Vol.14, 100385
DOI: 10.1016/j.resplu.2023.100385
PMID: 37065731
PMCID: PMC10090648
NLM abbreviation: Resusc Plus
ISSN: 2666-5204
eISSN: 2666-5204
Publisher: Elsevier B.V
Language: English
Date published: 06/2023
Academic Unit: Emergency Medicine
Record Identifier: 9984386255402771

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