Admission of out-of-hospital cardiac arrest victims to a high volume cardiac arrest center is linked to improved outcome. (September 2016)

• Record Type: Journal Article
• Authors: Schober, Andreas; Sterz, Fritz; Laggner, Anton N.; Poppe, Michael; Sulzgruber, Patrick; Lobmeyr, Elisabeth; Datler, Philip; Keferböck, Markus; Zeiner, Sebastian; Nuernberger, Alexander; Eder, Bettina; Hinterholzer, Georg; Mydza, Daniel; Enzelsberger, Barbara; Herbich, Klaus; Schuster, Reinhard; Koeller, Elke; Publig, Thomas; Smetana, Peter; Scheibenpflug, Chrisitian; Christ, Günter; Meyer, Brigitte; Uray, Thomas
• Is Part Of: Resuscitation. Volume 106(2016)
• Page Start: 42
• Page End: 48
• Publication Date: 2016-09
• Subjects: Cardiopulmonary resuscitation -- Hospitals -- Outcome assessment (health care) -- Out-of-hospital cardiac arrest; Resuscitation -- Periodicals; Resuscitation -- Periodicals; Réanimation -- Périodiques; Electronic journals; 616.025
• DOI: 10.1016/j.resuscitation.2016.06.021
• Languages: English
• ISSNs: 0300-9572

Abstract

Abstract: Aim: Cardiac arrest centers have been associated with improved outcome for patients after cardiac arrest. Aim of this study was to investigate the effect on outcome depending on admission to high-, medium- or low volume centers. Methods: Analysis from a prospective, multicenter registry for out of hospital cardiac arrest patients treated by the emergency medical service of Vienna, Austria. The frequency of cardiac arrest patients admitted per center/year (low <50; medium 50–100; high >100) was correlated to favorable outcome (30-day survival with cerebral performance category of 1 or 2). Results: Out of 2238 patients (years 2013–2015) with emergency medical service resuscitation, 861 (32% female, age 64 (51;73) years) were admitted to 7 different centers. Favorable outcome was achieved in 267 patients (31%). Survivors were younger (58 vs. 66 years; p < 0.001), showed shockable initial heart rhythm more frequently (72 vs. 35%; p < 0.001), had shorter CPR durations (22 vs. 29 min; p < 0.001) and were more likely to be treated in a high frequency center (OR 1.6; CI: 1.2–2.1; p = 0.001). In multivariate analysis, age below 65 years (OR 15; CI: 3.3–271.4; p = 0.001), shockable initial heart rhythm (OR 10.1; CI: 2.4–42.6; p = 0.002), immediate bystander or emergency medical service CPR (OR 11.2; CI: 1.4–93.3; p = 0.025) and admission to a center with a frequency of >100 OHCA patients/year (OR 5.2; CI: 1.2–21.7; p = 0.025) was associated with favorable outcome. Conclusions: High frequency of post-cardiac arrest treatment in a specialized center seems to be an independent predictor for favorable outcome in an unselected population of patients after out of hospital cardiac arrest.