Jeong Ho Park1, Seung Chul Lee2, Sang Do Shin3, Kyoung Jun Song4, Ki Jeong Hong5, Young Sun Ro6. 1. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: timthe@gmail.com. 2. Department of Emergency Medicine, Dongguk University Ilsan Hospital, Goyang-si, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: emsscl0126@gmail.com. 3. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: shinsangdo@medimail.co.kr. 4. Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: skciva@gmail.com. 5. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: emkjhong@gmail.com. 6. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: ro.youngsun@gmail.com.
Abstract
INTRODUCTION: Post-resuscitation care of out-of-hospital cardiac arrest (OHCA) patients often involves inter-hospital transfer (IHT). We aimed to determine the association between IHT and outcomes of OHCA. METHODS: This cross-sectional study used data from the nationwide emergency medical services (EMS)-based OHCA registry in Korea. All cases of adult patients with OHCA with a presumed cardiac aetiology and a sustained return of spontaneous circulation (ROSC) at hospitals between 2015 and 2016 were analysed. The primary outcome was a good neurological recovery at discharge, defined as cerebral performance in categories 1 or 2. We compared the primary outcome between a non-IHT group and an IHT group, using a propensity score-matching analysis. All analyses were performed separately by mean annual volume of patients with OHCA initially visiting high-volume emergency departments (HVEDs; >100 OCHA patients) and low-volume emergency departments (LVEDs; ≤100 OHCA patients). RESULTS: Of 54,779 OHCA patients, 11,632 were included. Of 4477 patients who visited LVEDs initially, 1360 (30%) patients were transferred. Of 7155 patients who visited HVEDs initially, 604 (8%) patients were transferred. In the propensity score-matching analysis, the IHT group was more likely to have good neurological recovery than was the non-IHT group [adjusted odds ratio (OR): 1.34; 95% confidence interval (CI): 1.07-1.67] in LVED visitors, but there was no significant difference of good neurological recovery between the non-IHT group and the IHT group (adjusted OR: 0.84; 95% CI: 0.63-1.13) in HVED visitors. CONCLUSION: IHT should be considered when treating OHCA patients in LVEDs.
INTRODUCTION: Post-resuscitation care of out-of-hospital cardiac arrest (OHCA) patients often involves inter-hospital transfer (IHT). We aimed to determine the association between IHT and outcomes of OHCA. METHODS: This cross-sectional study used data from the nationwide emergency medical services (EMS)-based OHCA registry in Korea. All cases of adult patients with OHCA with a presumed cardiac aetiology and a sustained return of spontaneous circulation (ROSC) at hospitals between 2015 and 2016 were analysed. The primary outcome was a good neurological recovery at discharge, defined as cerebral performance in categories 1 or 2. We compared the primary outcome between a non-IHT group and an IHT group, using a propensity score-matching analysis. All analyses were performed separately by mean annual volume of patients with OHCA initially visiting high-volume emergency departments (HVEDs; >100 OCHA patients) and low-volume emergency departments (LVEDs; ≤100 OHCA patients). RESULTS: Of 54,779 OHCA patients, 11,632 were included. Of 4477 patients who visited LVEDs initially, 1360 (30%) patients were transferred. Of 7155 patients who visited HVEDs initially, 604 (8%) patients were transferred. In the propensity score-matching analysis, the IHT group was more likely to have good neurological recovery than was the non-IHT group [adjusted odds ratio (OR): 1.34; 95% confidence interval (CI): 1.07-1.67] in LVED visitors, but there was no significant difference of good neurological recovery between the non-IHT group and the IHT group (adjusted OR: 0.84; 95% CI: 0.63-1.13) in HVED visitors. CONCLUSION: IHT should be considered when treating OHCA patients in LVEDs.
Authors: Amelia Xin Chun Goh; Jie Cong Seow; Melvin Yong Hao Lai; Nan Liu; Yi Man Goh; Marcus Eng Hock Ong; Shir Lynn Lim; Jamie Sin Ying Ho; Jun Wei Yeo; Andrew Fu Wah Ho Journal: JAMA Netw Open Date: 2022-05-02
Authors: Yoon Hee Choi; Dong Hoon Lee; Je Hyeok Oh; Jin Hong Min; Tae Chang Jang; Won Young Kim; Won Jung Jeong; Je Sung You Journal: J Clin Med Date: 2020-06-24 Impact factor: 4.241
Authors: Jun Wei Yeo; Zi Hui Celeste Ng; Amelia Xin Chun Goh; Jocelyn Fangjiao Gao; Nan Liu; Shao Wei Sean Lam; Yew Woon Chia; Gavin D Perkins; Marcus Eng Hock Ong; Andrew Fu Wah Ho Journal: J Am Heart Assoc Date: 2021-12-20 Impact factor: 6.106