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Post-cardiac arrest mortality declining in US hospitals
The in-hospital mortality rate of patients hospitalized with cardiac arrest in the United States decreased by more than 11% from 2001 to 2009.
During this period, 1,190,860 patients were hospitalized with a diagnosis of cardiac arrest. Researchers calculated that, on average, 132,318 patients were affected by cardiac arrest per year.
The in-hospital mortality rate declined from 69.6% in 2001 to 57.8% in 2009. The decrease was observed across all analyzed subgroups, including age, sex and race. The rate was highest for patients aged 80 years and older (74.6%), as compared with patients aged 65 to 79 years (64.3%) and younger than 65 years (59.5%). The in-hospital mortality rate declined “despite a rise in the proportion of patients with high comorbidity indices over time, and the decline … was more pronounced in patients with more comorbidities,” the researchers wrote in the study.
Other results from the study showed that the proportion of patients treated at large volume centers increased from 64.4% in 2001 to 67.4% in 2009. In addition, the percent of patients who underwent coronary catheterization increased by about 3% and percutaneous transluminal coronary angioplasty by about 2%.
The data were compiled using the 2001-2009 US National Inpatient Sample.
Several factors may have contributed to these findings, the researchers said, including advances in post-resuscitation care; new guidelines for CPR and automated external defibrillator use; and the introduction of therapeutic hypothermia.
However, “the cause of this decreased mortality cannot be established with certainty,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
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This is particularly good news, given that asystole and pulseless electrical activity appear to make up a larger proportion of the arrest arrhythmias than in the past. They carry worse prognoses than do the tachyarrhythmias and fibrillation. Despite this, survival is improving.