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Survival, neurologic outcomes improved in cardiac arrest patients
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Patients at hospitals participating in a large quality improvement registry experienced better survival and neurologic outcomes after in-hospital cardiac arrest during the past decade, according to data published in The New England Journal of Medicine.
From 2000 to 2009, risk-adjusted rates of survival to hospital discharge increased from 13.7% to 22.3% (adjusted rate ratio per year=1.04; 95% CI, 1.03-1.06) among 84,625 patients with cardiac arrest at hospitals participating in the Get with the Guidelines–Resuscitation registry. Additionally, results indicated that risk-adjusted rates of clinically significant neurologic disability decreased from 32.9% in 2000 to 28.1% in 2009 among survivors (adjusted rate ratio per year=0.98; 95% CI, 0.97-1).
The researchers also found a trend toward an increased proportion of cardiac arrests attributable to asystole or pulseless electrical activity over time (P<.001 for trend), with 79.3% of patients included in the study experiencing an initial rhythm of asystole or pulseless electrical activity and 20.7% experiencing ventricular fibrillation or pulseless ventricular tachycardia. Improvement in survival, however, was similar in the two rhythm groups. The researchers said improved survival was related to improvements in acute resuscitation survival and post-resuscitation survival.
Trends in survival were independent of how long the hospitals had been participating in the Get with the Guidelines–Resuscitation registry, the researchers said.
Despite the positive findings, several study limitations should be taken into account when interpreting the data, the researchers wrote. They highlighted a lack of detailed information on specific resuscitation process variables, treatments and quality improvement initiatives at hospitals. Additionally, they said hospitals participating in the registry were most likely motivated for quality improvement.
Disclosure: See the study for a full list of financial disclosures.
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