Johannes von Vopelius-Feldt1, Gavin D Perkins2, Jonathan Benger3. 1. Emergency Department, North Bristol NHS Trust, United Kingdom; Emergency Care Research Group, University of the West of England Bristol, United Kingdom. Electronic address: johannes.vonvopelius-feldt@nbt.nhs.uk. 2. Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom. 3. Emergency Care Research Group, University of the West of England Bristol, United Kingdom; Academic Department of Emergency Medicine, University Hospitals Bristol and Weston NHS Foundation Trust, United Kingdom.
Abstract
AIM: This study examined the association between admission to a cardiac arrest centre and survival to hospital discharge for adults following out-of-hospital cardiac arrest (OHCA). METHODS: We undertook a multicentre retrospective observational study of patients transferred to hospital after OHCA of presumed cardiac aetiology in three ambulance services in England. We used propensity score matching to compare rates of survival to hospital discharge in patients admitted to OHCA centres (defined as either 24/7 PPCI availability or >100 OHCA admissions per year) to rates of survival of patients admitted to non-centres. RESULTS: Between January 2017 and December 2018, 10,650 patients with OHCA were included in the analysis. After propensity score matching, admission to a hospital with 24/7 PPCI availability or a high volume centre was associated with an absolute improvement in survival to hospital discharge of 2.5% and 2.8%, respectively. The corresponding odds ratios and 95% confidence intervals were 1.69 (1.28-2.23) and 1.41 (1.14-1.75), respectively. The results were similar when missing values were imputed. In subgroup analyses, the association between admission to an OHCA centre and improved rates of survival was mainly seen in patients with OHCA due to shockable rhythms, with no or minimal potential benefit for patients with OHCA and asystole as first presenting rhythm. CONCLUSION: Following OHCA, admission to a cardiac arrest centre is associated with a moderate improvement in survival to hospital discharge. A corresponding bypass policy would need to consider the resulting increased workload for OHCA centres.
AIM: This study examined the association between admission to a cardiac arrest centre and survival to hospital discharge for adults following out-of-hospital cardiac arrest (OHCA). METHODS: We undertook a multicentre retrospective observational study of patients transferred to hospital after OHCA of presumed cardiac aetiology in three ambulance services in England. We used propensity score matching to compare rates of survival to hospital discharge in patients admitted to OHCA centres (defined as either 24/7 PPCI availability or >100 OHCA admissions per year) to rates of survival of patients admitted to non-centres. RESULTS: Between January 2017 and December 2018, 10,650 patients with OHCA were included in the analysis. After propensity score matching, admission to a hospital with 24/7 PPCI availability or a high volume centre was associated with an absolute improvement in survival to hospital discharge of 2.5% and 2.8%, respectively. The corresponding odds ratios and 95% confidence intervals were 1.69 (1.28-2.23) and 1.41 (1.14-1.75), respectively. The results were similar when missing values were imputed. In subgroup analyses, the association between admission to an OHCA centre and improved rates of survival was mainly seen in patients with OHCA due to shockable rhythms, with no or minimal potential benefit for patients with OHCA and asystole as first presenting rhythm. CONCLUSION: Following OHCA, admission to a cardiac arrest centre is associated with a moderate improvement in survival to hospital discharge. A corresponding bypass policy would need to consider the resulting increased workload for OHCA centres.
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: 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