Effect of annual hospital admissions of out-of-hospital cardiac arrest patients on prognosis following cardiac arrest

BMC Emergency Medicine

Research

Mineji Hayakawa¹  Kunihiko Maekawa¹  Mariko Hayamizu¹  Takumi Tsuchida¹  Kota Ono² 

[1] Department of Emergency Medicine, Hokkaido University Hospital, N14W5 Kita-ku, 060-8648, Sapporo, Japan;Ono Biostat Consulting, Narita-higashi, Suginami-ku, 166-0015, Tokyo, Japan;

关键词: Cardiopulmonary resuscitation;    Hospital volume;    Neurological outcome;    Out-of-hospital cardiac arrest;    Prediction;    Prognosis;   

DOI  :  10.1186/s12873-022-00685-7

 received in 2022-03-13, accepted in 2022-06-29,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundAlthough the prognosis of patients treated at specialized facilities has improved, the relationship between the number of patients treated at hospitals and prognosis is controversial and lacks constancy in those with out-of-hospital cardiac arrest (OHCA). This study aimed to clarify the effect of annual hospital admissions on the prognosis of adult patients with OHCA by analyzing a large cohort.MethodsThe effect of annual hospital admissions on patient prognosis was analyzed retrospectively using data from the Japanese Association for Acute Medicine OHCA registry, a nationwide multihospital prospective database. This study analyzed 3632 of 35,754 patients hospitalized for OHCA of cardiac origin at 86 hospitals. The hospitals were divided into tertiles based on the volume of annual admissions. The effect of hospital volume on prognosis was analyzed using logistic regression analysis with multiple imputation. Furthermore, three subgroup analyses were performed for patients with return of spontaneous circulation (ROSC) before arrival at the emergency department, patients admitted to critical care medical centers, and patients admitted to extracorporeal membrane oxygenation-capable hospitals.ResultsFavorable neurological outcomes 30 days after OHCA for patients overall showed no advantage for medium- and high-volume centers over low-volume centers; Odds ratio (OR) 0.989, (95% Confidence interval [CI] 0.562-1.741), OR 1.504 (95% CI 0.919-2.463), respectively. However, the frequency of favorable neurological outcomes in OHCA patients with ROSC before arrival at the emergency department at high-volume centers was higher than those at low-volume centers (OR 1.955, 95% CI 1.033-3.851).ConclusionHospital volume did not significantly affect the prognosis of adult patients with OHCA. However, transport to a high-volume hospital may improve the neurological prognosis in OHCA patients with ROSC before arrival at the emergency department.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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