Mathias J Holmberg1, Asger Granfeldt2, Saket Girotra3, Michael W Donnino4, Lars W Andersen5. 1. Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Cardiology, Viborg Regional Hospital, Viborg, Denmark. 2. Department of Intensive Care Medicine, Randers Regional Hospital, Randers, Denmark; Department of Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark. 3. Carver College of Medicine, University of Iowa, Iowa City, IA, USA. 4. Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA. 5. Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Prehospital Emergency Medical Services, Central Denmark Region, Denmark; Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark. Electronic address: lwandersen@clin.au.dk.
Abstract
AIMS: To examine trends in survival from 2006 to 2018 and to assess whether the introduction of resuscitation guidelines was associated with a change in survival after adult in-hospital cardiac arrest. METHODS: Using the Get With The Guidelines® - Resuscitation registry, we included adult patients with an in-hospital cardiac arrest between 2006 and 2018. The primary outcome was survival to hospital discharge. An interrupted time series analysis was used to compare survival before and after publication of the 2010 and 2015 resuscitation guidelines. RESULTS: The analysis included 231,739 patients. Survival changed annually by 1.09% (95% CI, 0.74% to 1.43%; P < 0.001) from 2006 to 2010, 0.26% (95% CI, -0.11% to 0.64%; P = 0.17) from 2011 to 2015, and -0.43% (95% CI, -0.96% to 0.11%; P = 0.12) from 2016 to 2018. The survival trend was lower within the post-2010 compared to the pre-2010 period (risk difference, -0.82% per year; 95% CI, -1.35% to -0.30%; P = 0.002) and within the post-2015 compared to the pre-2015 period (risk difference, -0.69% per year; 95% CI, -1.33% to -0.04%; P = 0.04). There was no immediate change in survival after publication of the 2010 and 2015 guidelines. CONCLUSIONS: In-hospital cardiac arrest survival increased from 2006 to 2010, after which the trend plateaued. The annual survival trend was lower following publication of the 2010 and 2015 guidelines. Research targeting in-hospital cardiac arrest as a unique entity may be necessary to improve outcomes.
AIMS: To examine trends in survival from 2006 to 2018 and to assess whether the introduction of resuscitation guidelines was associated with a change in survival after adult in-hospital cardiac arrest. METHODS: Using the Get With The Guidelines® - Resuscitation registry, we included adult patients with an in-hospital cardiac arrest between 2006 and 2018. The primary outcome was survival to hospital discharge. An interrupted time series analysis was used to compare survival before and after publication of the 2010 and 2015 resuscitation guidelines. RESULTS: The analysis included 231,739 patients. Survival changed annually by 1.09% (95% CI, 0.74% to 1.43%; P < 0.001) from 2006 to 2010, 0.26% (95% CI, -0.11% to 0.64%; P = 0.17) from 2011 to 2015, and -0.43% (95% CI, -0.96% to 0.11%; P = 0.12) from 2016 to 2018. The survival trend was lower within the post-2010 compared to the pre-2010 period (risk difference, -0.82% per year; 95% CI, -1.35% to -0.30%; P = 0.002) and within the post-2015 compared to the pre-2015 period (risk difference, -0.69% per year; 95% CI, -1.33% to -0.04%; P = 0.04). There was no immediate change in survival after publication of the 2010 and 2015 guidelines. CONCLUSIONS: In-hospital cardiac arrest survival increased from 2006 to 2010, after which the trend plateaued. The annual survival trend was lower following publication of the 2010 and 2015 guidelines. Research targeting in-hospital cardiac arrest as a unique entity may be necessary to improve outcomes.
Authors: Lingling Wu; Bharat Narasimhan; Kirtipal Bhatia; Kam S Ho; Chayakrit Krittanawong; Wilbert S Aronow; Patrick Lam; Salim S Virani; Salpy V Pamboukian Journal: J Am Heart Assoc Date: 2021-12-02 Impact factor: 6.106
Authors: Lars W Andersen; Birthe Sindberg; Mathias Holmberg; Dan Isbye; Jesper Kjærgaard; Stine T Zwisler; Søren Darling; Jacob Moesgaard Larsen; Bodil S Rasmussen; Bo Løfgren; Kasper Glerup Lauridsen; Kim B Pælestik; Christoffer Sølling; Anders G Kjærgaard; Dorte Due-Rasmussen; Fredrik Folke; Mette Gitz Charlot; Kasper Iversen; Martin Schultz; Sebastian Wiberg; Rikke Malene H G Jepsen; Tobias Kurth; Michael Donnino; Hans Kirkegaard; Asger Granfeldt Journal: Resusc Plus Date: 2021-01-30