Interhospital variability in Out-of-Hospital cardiac arrest survival in a large metropolitan area
Background: 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. Methods: This was a retrospective analysis of a...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-06-01
|
| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520423000280 |
| _version_ | 1797854282716807168 |
|---|---|
| author | Pavitra Kotini-Shah Nicole Blum Shaveta Khosla Joseph Weber Eddie Markul Katie Tataris Teri Campbell Terry Vanden Hoek Marina Del Rios |
| author_facet | Pavitra Kotini-Shah Nicole Blum Shaveta Khosla Joseph Weber Eddie Markul Katie Tataris Teri Campbell Terry Vanden Hoek Marina Del Rios |
| author_sort | Pavitra Kotini-Shah |
| collection | DOAJ |
| description | Background: 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. Methods: 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. Results: 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). Conclusion: 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. |
| first_indexed | 2024-04-09T20:04:31Z |
| format | Article |
| id | doaj.art-ac86dfe76ab0497a91058c7f30be1de1 |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-04-09T20:04:31Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-ac86dfe76ab0497a91058c7f30be1de12023-04-02T06:15:15ZengElsevierResuscitation Plus2666-52042023-06-0114100385Interhospital variability in Out-of-Hospital cardiac arrest survival in a large metropolitan areaPavitra Kotini-Shah0Nicole Blum1Shaveta Khosla2Joseph Weber3Eddie Markul4Katie Tataris5Teri Campbell6Terry Vanden Hoek7Marina Del Rios8Department of Emergency Medicine, University of Illinois at Chicago, Chicago, IL, USADepartment of Emergency Medicine, University of Chicago, Chicago, IL, USADepartment of Emergency Medicine, University of Illinois at Chicago, Chicago, IL, USADepartment of Emergency Medicine, John H. Stroger, Jr. Hospital, Chicago, IL, USAIllinois Masonic Medical Center, Chicago, IL, USADepartment of Emergency Medicine, University of Chicago, Chicago, IL, USADepartment of Emergency Medicine, University of Illinois at Chicago, Chicago, IL, USADepartment of Emergency Medicine, University of Illinois at Chicago, Chicago, IL, USADepartment of Emergency Medicine, University of Iowa, Iowa City, IA, USA; Corresponding author at: Department of Emergency Medicine, University of Iowa – Carver College of Medicine, 200 Hawkins Drive, 1008 RCP, Iowa City, IA 52242, USA.Background: 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. Methods: 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. Results: 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). Conclusion: 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.http://www.sciencedirect.com/science/article/pii/S2666520423000280Out of Hospital Cardiac ArrestInterhospital variabilitySurvivalNeurologic outcomes |
| spellingShingle | Pavitra Kotini-Shah Nicole Blum Shaveta Khosla Joseph Weber Eddie Markul Katie Tataris Teri Campbell Terry Vanden Hoek Marina Del Rios Interhospital variability in Out-of-Hospital cardiac arrest survival in a large metropolitan area Resuscitation Plus Out of Hospital Cardiac Arrest Interhospital variability Survival Neurologic outcomes |
| title | Interhospital variability in Out-of-Hospital cardiac arrest survival in a large metropolitan area |
| title_full | Interhospital variability in Out-of-Hospital cardiac arrest survival in a large metropolitan area |
| title_fullStr | Interhospital variability in Out-of-Hospital cardiac arrest survival in a large metropolitan area |
| title_full_unstemmed | Interhospital variability in Out-of-Hospital cardiac arrest survival in a large metropolitan area |
| title_short | Interhospital variability in Out-of-Hospital cardiac arrest survival in a large metropolitan area |
| title_sort | interhospital variability in out of hospital cardiac arrest survival in a large metropolitan area |
| topic | Out of Hospital Cardiac Arrest Interhospital variability Survival Neurologic outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2666520423000280 |
| work_keys_str_mv | AT pavitrakotinishah interhospitalvariabilityinoutofhospitalcardiacarrestsurvivalinalargemetropolitanarea AT nicoleblum interhospitalvariabilityinoutofhospitalcardiacarrestsurvivalinalargemetropolitanarea AT shavetakhosla interhospitalvariabilityinoutofhospitalcardiacarrestsurvivalinalargemetropolitanarea AT josephweber interhospitalvariabilityinoutofhospitalcardiacarrestsurvivalinalargemetropolitanarea AT eddiemarkul interhospitalvariabilityinoutofhospitalcardiacarrestsurvivalinalargemetropolitanarea AT katietataris interhospitalvariabilityinoutofhospitalcardiacarrestsurvivalinalargemetropolitanarea AT tericampbell interhospitalvariabilityinoutofhospitalcardiacarrestsurvivalinalargemetropolitanarea AT terryvandenhoek interhospitalvariabilityinoutofhospitalcardiacarrestsurvivalinalargemetropolitanarea AT marinadelrios interhospitalvariabilityinoutofhospitalcardiacarrestsurvivalinalargemetropolitanarea |