Variability in functional outcome and treatment practices by treatment center after out-of-hospital cardiac arrest: analysis of International Cardiac Arrest Registry

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Variability in functional outcome and treatment practices by treatment center after out-of-hospital cardiac arrest : analysis of International Cardiac Arrest Registry

May, Teresa L. (författare): Maine Med Ctr, Dept Crit Care Serv, 22 Bramhall St, Portland, ME 04102 USA;Tufts Univ, Clin & Translat Sci Inst, Boston, MA 02111 USA,Maine Medical Center

Lary, Christine W. (författare): Maine Med Ctr, Ctr Outcomes Res, Portland, ME 04102 USA,Maine Medical Center

Riker, Richard R. (författare): Maine Med Ctr, Dept Crit Care Serv, 22 Bramhall St, Portland, ME 04102 USA,Maine Medical Center

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Friberg, Hans (författare): Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SWECRIT,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital

Patel, Nainesh (författare): Lehigh Valley Hosp & Hlth Network, Div Cardiovasc Med, Allentown, PA USA,Lehigh Valley Hospital

Soreide, Eldar (författare): Stavanger Univ Hosp, Crit Care & Anesthesiol Res Grp, Stavanger, Norway;Univ Bergen, Dept Clin Med, Bergen, Norway,Stavanger University Hospital,University of Bergen

McPherson, John A. (författare): Vanderbilt Univ, Med Ctr, Div Cardiovasc Med, Nashville, TN USA,Vanderbilt University

Undén, Johan (författare): Lund University,Lunds universitet,Anestesiologi och intensivvård,Forskargrupper vid Lunds universitet,Anaesthesiology and Intensive Care Medicine,Lund University Research Groups,Skåne University Hospital

Hand, Robert (författare): Eastern Maine Med Ctr, Dept Crit Care, Bangor, ME USA,Eastern Maine Medical Center

Sunde, Kjetil (författare): Oslo Univ Hosp, Dept Anaesthesiol, Div Emergencies & Crit Care, Oslo, Norway;Univ Oslo, Inst Clin Med, Oslo, Norway,Oslo university hospital,University of Oslo

Stammet, Pascal (författare): Med Dept Natl Rescue Serv, 14 Rue Stumper, L-2557 Luxembourg, Luxembourg,Luxembourg Rescue Services Agency

Rubertsson, Sten (författare): Uppsala University,Uppsala universitet,Anestesiologi och intensivvård

Belohlvaek, Jan (författare): Charles Univ Prague, Dept Internal Med 2, Cardiovasc Med, Gen Teaching Hosp, Prague, Czech Republic;Charles Univ Prague, Med Sch 1, Prague, Czech Republic,General University Hospital in Prague

Dupont, Allison (författare): Northeast Georgia Med Ctr, Dept Cardiol, Gainesville, FL USA

Hirsch, Karen G. (författare): Stanford Univ, Sch Med, Dept Neurol & Neurol Surg, Stanford Neurocrit Care Program, Stanford, CA 94305 USA,Stanford University

Valsson, Felix (författare): Landspitali Univ Hosp, Dept Anesthesia & Intens Care, Reykyavik, Iceland,National University Hospital of Iceland

Kern, Karl (författare): Univ Arizona, Div Cardiol, Sarver Heart Ctr, Tucson, AZ USA,University of Arizona

Sadaka, Farid (författare): St Louis Univ, Mercy Hosp St Louis, St Louis, MO 63103 USA,Saint Louis University School of Medicine

Israelsson, Johan (författare): Kalmar Cty Hosp, Dept Internal Med, Div Cardiol, Kalmar, Sweden,Kalmar County Hospital

Dankiewicz, Josef (författare): Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Vanderbilt University

Nielsen, Niklas (författare): Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Kliniska Vetenskaper, Helsingborg,Institutionen för kliniska vetenskaper, Lund,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical Sciences, Helsingborg,Department of Clinical Sciences, Lund,Center for cardiac arrest,Lund University Research Groups,Helsingborg Hospital

Seder, David B. (författare): Maine Med Ctr, Dept Crit Care Serv, 22 Bramhall St, Portland, ME 04102 USA

Agarwal, Sachin (författare): Columbia Presbyterian Med Ctr, Dept Neurol, New York, NY 10032 USA,New York Presbyterian Hospital/Columbia University Medical Center

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2019-03-08
2019
Engelska.
Ingår i: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 45:5, s. 637-646

Relaterad länk:: https://link.springe...; visa fler...; http://dx.doi.org/10...; https://urn.kb.se/re...; https://doi.org/10.1...; https://lup.lub.lu.s...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

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PurposeFunctional outcomes vary between centers after out-of-hospital cardiac arrest (OHCA) and are partially explained by pre-existing health status and arrest characteristics, while the effects of in-hospital treatments on functional outcome are less understood. We examined variation in functional outcomes by center after adjusting for patient- and arrest-specific characteristics and evaluated how in-hospital management differs between high- and low-performing centers.MethodsAnalysis of observational registry data within the International Cardiac Arrest Registry was used to perform a hierarchical model of center-specific risk standardized rates for good outcome, adjusted for demographics, pre-existing functional status, and arrest-related factors with treatment center as a random effect variable. We described the variability in treatments and diagnostic tests that may influence outcome at centers with adjusted rates significantly above and below registry average.ResultsA total of 3855 patients were admitted to an ICU following cardiac arrest with return of spontaneous circulation. The overall prevalence of good outcome was 11-63% among centers. After adjustment, center-specific risk standardized rates for good functional outcome ranged from 0.47 (0.37-0.58) to 0.20 (0.12-0.26). High-performing centers had faster time to goal temperature, were more likely to have goal temperature of 33 degrees C, more likely to perform unconscious cardiac catheterization and percutaneous coronary intervention, and had differing prognostication practices than low-performing centers.ConclusionsCenter-specific differences in outcomes after OHCA after adjusting for patient-specific factors exist. This variation could partially be explained by in-hospital management differences. Future research should address the contribution of these factors to the differences in outcomes after resuscitation.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Cardiac arrest
Center variability
Out of hospital arrest
Cardiac arrest
Center variability
Out of hospital arrest

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Anestesi och int ...

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