Large urban center improves out-of-hospital cardiac arrest survival

Marina Del Rios; Joseph Weber; Oksana Pugach; Hai Nguyen; Teri Campbell; Salman Islam; Leslee Stein Spencer; Eddie Markul; E. Bradshaw Bunney; Terry Vanden Hoek

doi:10.1016/j.resuscitation.2019.04.019

Back

Large urban center improves out-of-hospital cardiac arrest survival

Journal article

Peer reviewed

Large urban center improves out-of-hospital cardiac arrest survival

Marina Del Rios, Joseph Weber, Oksana Pugach, Hai Nguyen, Teri Campbell, Salman Islam, Leslee Stein Spencer, Eddie Markul, E. Bradshaw Bunney and Terry Vanden Hoek

Resuscitation, Vol.139, pp.234-240

06/2019

DOI: 10.1016/j.resuscitation.2019.04.019

PMID: 31009693

View Online

Abstract

Large cities pose unique challenges that limit the effectiveness of system improvement interventions. Successful implementation of integrated cardiac resuscitation systems of care can serve as a model for other urban centers. This was a retrospective analysis of prospectively collected data of adult cases of non-traumatic cardiac arrest who received treatment by Chicago Fire Department EMS from September 1, 2013 through December 31, 2016. We measured temporal OHCA outcomes during implementation of system-wide initiatives including telephone-assisted and community CPR training programs; high performance CPR and team based simulation training; new post resuscitation care and destination protocols; and case review for EMS providers. Outcomes measured included bystander CPR rates, return of spontaneous circulation (ROSC), hospital admission and survival, and favorable neurologic outcomes (CPC 1–2). Relative risk was determined by logistic regression model where observed group-specific outcomes are expressed as odds ratios (OR). We included 6103 adult OHCA cases occurring outside of health care facilities from September 1, 2013 through December 31, 2016. Significantly improved outcomes (p < 0.05) were observed between 2013 and 2016 for bystander CPR (11.6% vs 19.4%), ROSC (28.6% vs 36.9%), hospital admission (22.5% vs 29.4%), survival (7.3% vs 9.9%), and CPC 1–2 (4.3% vs 6.4%). Utstein survival increased from 16.3%–35.4% and CPC 1–2 survival from 11.6%–29.1% (p < 0.05). After adjustment for OHCA characteristics, survival with CPC 1–2 increased over time (OR 1.15, p = 0.0277). Densely populated cities with low survival rates can overcome systematic challenges and improve OHCA survival.

Neurological outcomes

Out of hospital cardiac arrest

Prehospital

Quality improvement

Resuscitation

Systems of care

Details

Title: Subtitle: Large urban center improves out-of-hospital cardiac arrest survival
Creators: Marina Del Rios - University of Illinois at Chicago
Joseph Weber - Cook County Health and Hospitals System
Oksana Pugach - University of Illinois at Chicago
Hai Nguyen - University of Illinois at Chicago
Teri Campbell - University of Chicago
Salman Islam - University of Illinois at Chicago
Leslee Stein Spencer - Illinois Department of Public Health
Eddie Markul - Advocate Illinois Masonic Medical Center
E. Bradshaw Bunney - University of Illinois at Chicago
Terry Vanden Hoek - University of Illinois at Chicago
Resource Type: Journal article
Publication Details: Resuscitation, Vol.139, pp.234-240
Publisher: Elsevier B.V
DOI: 10.1016/j.resuscitation.2019.04.019
PMID: 31009693
ISSN: 0300-9572
eISSN: 1873-1570
Grant note: DOI: 10.13039/100000968, name: American Heart Association, award: 16MCPRP30960065
Language: English
Date published: 06/2019
Academic Unit: Emergency Medicine
Record Identifier: 9984297149302771

Metrics

24 Record Views

19 Times Cited - Web of Science

See more details