Impact of Transport Time and Cardiac Arrest Centers on the Neurological Outcome After Out‐of‐Hospital Cardiac Arrest: A Retrospective Cohort Study
Background Should all out‐of‐hospital cardiac arrest (OHCA) patients be directly transported to cardiac arrest centers (CACs) remains under debate. Our study evaluated the impacts of different transport time and destination hospital on the outcomes of OHCA patients. Methods and Results Data were col...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.015544 |
| _version_ | 1819183208174977024 |
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| author | Cheng‐Yu Chien Shang‐Li Tsai Li‐Heng Tsai Chen‐Bin Chen Chen‐June Seak Yi‐Ming Weng Chi‐Chun Lin Chip‐Jin Ng Wei‐Che Chien Chien‐Hsiung Huang Cheng‐Yu Lin Chung‐Hsien Chaou Peng‐Huei Liu Hsiao‐Jung Tseng Chi‐Tai Fang |
| author_facet | Cheng‐Yu Chien Shang‐Li Tsai Li‐Heng Tsai Chen‐Bin Chen Chen‐June Seak Yi‐Ming Weng Chi‐Chun Lin Chip‐Jin Ng Wei‐Che Chien Chien‐Hsiung Huang Cheng‐Yu Lin Chung‐Hsien Chaou Peng‐Huei Liu Hsiao‐Jung Tseng Chi‐Tai Fang |
| author_sort | Cheng‐Yu Chien |
| collection | DOAJ |
| description | Background Should all out‐of‐hospital cardiac arrest (OHCA) patients be directly transported to cardiac arrest centers (CACs) remains under debate. Our study evaluated the impacts of different transport time and destination hospital on the outcomes of OHCA patients. Methods and Results Data were collected from 6655 OHCA patients recorded in the regional prospective OHCA registry database of Taoyuan City, Taiwan, between January 2012 and December 2016. Patients were matched on propensity score, which left 5156 patients, 2578 each in the CAC and non‐CAC groups. Transport time was dichotomized into <8 and ≥8 minutes. The relations between the transport time to CACs and good neurological outcome at discharge and survival to discharge were investigated. Of the 5156 patients, 4215 (81.7%) presented with nonshockable rhythms and 941 (18.3%) presented with shockable rhythms. Regardless of transport time, transportation to a CAC increased the likelihoods of survival to discharge (<8 minutes: adjusted odds ratio [aOR], 1.95; 95% CI, 1.11–3.41; ≥8 minutes: aOR, 1.92; 95% CI, 1.25–2.94) and good neurological outcome at discharge (<8 minutes: aOR, 2.70; 95% CI, 1.40–5.22; ≥8 minutes: aOR, 2.20; 95% CI, 1.29–3.75) in OHCA patients with shockable rhythms but not in patients with nonshockable rhythms. Conclusions OHCA patients with shockable rhythms transported to CACs demonstrated higher probabilities of survival to discharge and a good neurological outcome at discharge. Direct ambulance delivery to CACs should thus be considered, particularly when OHCA patients present with shockable rhythms. |
| first_indexed | 2024-12-22T22:58:22Z |
| format | Article |
| id | doaj.art-30e0900f49674881a355b69027fa5abc |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-22T22:58:22Z |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-30e0900f49674881a355b69027fa5abc2022-12-21T18:09:44ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-06-0191110.1161/JAHA.119.015544Impact of Transport Time and Cardiac Arrest Centers on the Neurological Outcome After Out‐of‐Hospital Cardiac Arrest: A Retrospective Cohort StudyCheng‐Yu Chien0Shang‐Li Tsai1Li‐Heng Tsai2Chen‐Bin Chen3Chen‐June Seak4Yi‐Ming Weng5Chi‐Chun Lin6Chip‐Jin Ng7Wei‐Che Chien8Chien‐Hsiung Huang9Cheng‐Yu Lin10Chung‐Hsien Chaou11Peng‐Huei Liu12Hsiao‐Jung Tseng13Chi‐Tai Fang14Department of Emergency Medicine Chang Gung Memorial Hospital Linkou and College of Medicine Chang Gung University Tao‐Yuan TaiwanDepartment of Emergency Medicine Chang Gung Memorial Hospital Linkou and College of Medicine Chang Gung University Tao‐Yuan TaiwanDepartment of Emergency Medicine Chang Gung Memorial Hospital Linkou and College of Medicine Chang Gung University Tao‐Yuan TaiwanDepartment of Emergency Medicine Chang Gung Memorial Hospital Linkou and College of Medicine Chang Gung University Tao‐Yuan TaiwanDepartment of Emergency Medicine Chang Gung Memorial Hospital Linkou and College of Medicine Chang Gung University Tao‐Yuan TaiwanDepartment of Emergency Medicine Chang Gung Memorial Hospital Linkou and College of Medicine Chang Gung University Tao‐Yuan TaiwanDepartment of Emergency Medicine Chang Gung Memorial Hospital Linkou and College of Medicine Chang Gung University Tao‐Yuan TaiwanDepartment of Emergency Medicine Chang Gung Memorial Hospital Linkou and College of Medicine Chang Gung University Tao‐Yuan TaiwanDepartment of Emergency Medicine Chang Gung Memorial Hospital Linkou and College of Medicine Chang Gung University Tao‐Yuan TaiwanDepartment of Emergency Medicine Chang Gung Memorial Hospital Linkou and College of Medicine Chang Gung University Tao‐Yuan TaiwanDepartment of Emergency Medicine Ton‐Yen General Hospital Zhubei TaiwanDepartment of Emergency Medicine Chang Gung Memorial Hospital Linkou and College of Medicine Chang Gung University Tao‐Yuan TaiwanDepartment of Emergency Medicine Chang Gung Memorial Hospital Linkou and College of Medicine Chang Gung University Tao‐Yuan TaiwanBiostatistics Unit Clinical Trial Center Chang Gung Memorial Hospital Linkou TaiwanDepartment of Internal Medicine National Taiwan University Hospital Taipei TaiwanBackground Should all out‐of‐hospital cardiac arrest (OHCA) patients be directly transported to cardiac arrest centers (CACs) remains under debate. Our study evaluated the impacts of different transport time and destination hospital on the outcomes of OHCA patients. Methods and Results Data were collected from 6655 OHCA patients recorded in the regional prospective OHCA registry database of Taoyuan City, Taiwan, between January 2012 and December 2016. Patients were matched on propensity score, which left 5156 patients, 2578 each in the CAC and non‐CAC groups. Transport time was dichotomized into <8 and ≥8 minutes. The relations between the transport time to CACs and good neurological outcome at discharge and survival to discharge were investigated. Of the 5156 patients, 4215 (81.7%) presented with nonshockable rhythms and 941 (18.3%) presented with shockable rhythms. Regardless of transport time, transportation to a CAC increased the likelihoods of survival to discharge (<8 minutes: adjusted odds ratio [aOR], 1.95; 95% CI, 1.11–3.41; ≥8 minutes: aOR, 1.92; 95% CI, 1.25–2.94) and good neurological outcome at discharge (<8 minutes: aOR, 2.70; 95% CI, 1.40–5.22; ≥8 minutes: aOR, 2.20; 95% CI, 1.29–3.75) in OHCA patients with shockable rhythms but not in patients with nonshockable rhythms. Conclusions OHCA patients with shockable rhythms transported to CACs demonstrated higher probabilities of survival to discharge and a good neurological outcome at discharge. Direct ambulance delivery to CACs should thus be considered, particularly when OHCA patients present with shockable rhythms.https://www.ahajournals.org/doi/10.1161/JAHA.119.015544cardiac arrest centerinitial rhythmneurological outcomeout‐of‐hospital cardiac arresttransport time |
| spellingShingle | Cheng‐Yu Chien Shang‐Li Tsai Li‐Heng Tsai Chen‐Bin Chen Chen‐June Seak Yi‐Ming Weng Chi‐Chun Lin Chip‐Jin Ng Wei‐Che Chien Chien‐Hsiung Huang Cheng‐Yu Lin Chung‐Hsien Chaou Peng‐Huei Liu Hsiao‐Jung Tseng Chi‐Tai Fang Impact of Transport Time and Cardiac Arrest Centers on the Neurological Outcome After Out‐of‐Hospital Cardiac Arrest: A Retrospective Cohort Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiac arrest center initial rhythm neurological outcome out‐of‐hospital cardiac arrest transport time |
| title | Impact of Transport Time and Cardiac Arrest Centers on the Neurological Outcome After Out‐of‐Hospital Cardiac Arrest: A Retrospective Cohort Study |
| title_full | Impact of Transport Time and Cardiac Arrest Centers on the Neurological Outcome After Out‐of‐Hospital Cardiac Arrest: A Retrospective Cohort Study |
| title_fullStr | Impact of Transport Time and Cardiac Arrest Centers on the Neurological Outcome After Out‐of‐Hospital Cardiac Arrest: A Retrospective Cohort Study |
| title_full_unstemmed | Impact of Transport Time and Cardiac Arrest Centers on the Neurological Outcome After Out‐of‐Hospital Cardiac Arrest: A Retrospective Cohort Study |
| title_short | Impact of Transport Time and Cardiac Arrest Centers on the Neurological Outcome After Out‐of‐Hospital Cardiac Arrest: A Retrospective Cohort Study |
| title_sort | impact of transport time and cardiac arrest centers on the neurological outcome after out of hospital cardiac arrest a retrospective cohort study |
| topic | cardiac arrest center initial rhythm neurological outcome out‐of‐hospital cardiac arrest transport time |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.015544 |
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