scholarly journals Time to administration of epinephrine and outcome after in-hospital cardiac arrest with non-shockable rhythms: retrospective analysis of large in-hospital data registry

BMJ ◽  
2014 ◽  
Vol 348 (may20 2) ◽  
pp. g3028-g3028 ◽  
Author(s):  
M. W. Donnino ◽  
J. D. Salciccioli ◽  
M. D. Howell ◽  
M. N. Cocchi ◽  
B. Giberson ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Retrospective Analysis ◽  
Hospital Data ◽  
Data Registry ◽  
Hospital Cardiac Arrest

Abstract 226: Sex Differences in Cardiac Catheterization Following Out-of-Hospital Cardiac Arrest

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Bryn E Mumma ◽  
James F Holmes ◽  
Machelle D Wilson ◽  
Deborah B Diercks
Keyword(s):  
Cardiac Arrest ◽  
Sex Differences ◽  
Cardiac Catheterization ◽  
Health Planning ◽  
Acute Care Hospital ◽  
Coronary Intervention ◽  
Admission Diagnosis ◽  
Care Hospital ◽  
Hospital Data ◽  
Hospital Cardiac Arrest

Introduction: Cardiac catheterization is recommended for patients resuscitated from out-of-hospital cardiac arrest (OHCA) with a suspected cardiac etiology. Women are less likely than men to receive cardiac catheterization in other presentations of cardiovascular disease, but it remains unknown whether this disparity extends to OHCA. Objective: To determine whether patient sex is associated with undergoing cardiac catheterization after OHCA. Methods: We included all adult cases in the 2011 California Office of Statewide Health Planning and Development (OSHPD) database with a present-on-admission diagnosis of cardiac arrest (ICD-9-CM 427.5) or sudden cardiac death (ICD-9-CM 798) who were admitted from the emergency department to an acute care hospital. Data extracted from the OSHPD database included patient demographics, diagnoses, and procedures. ICD-9-CM procedure codes from the OSHPD database were used to identify patients who received cardiac catheterization. To determine factors associated with undergoing cardiac catheterization, we used a hierarchical logistic regression model that included age, sex, race, ethnicity, insurance type, ventricular arrest rhythm, and treatment at a hospital with 24/7 percutaneous coronary intervention capability. Results: We studied 4493 men and 3287 women admitted following OHCA. Women were older (median age 70 vs 64 years; p<0.001), had had fewer ventricular arrest rhythms (21.8% vs 31.7%; p<0.001), and received fewer cardiac catheterization procedures [12.5% vs 21.4%; p<0.0001]. This sex difference in cardiac catheterization persisted in the multivariable hierarchical model (adjusted OR 0.65; 95% CI 0.57-0.76; p<0.0001) and in a subgroup analysis including only patients with ventricular arrest rhythms (adjusted OR 0.63; 95% CI 0.51-0.78; p<0.0001) Conclusion: Sex differences exist in cardiac catheterization following resuscitation from OHCA. Future efforts should focus on understanding and resolving these differences.

scholarly journals Comparative Effectiveness of Therapeutic Hypothermia After Out-of-Hospital Cardiac Arrest: Insight from a Large Data Registry

2014 ◽  
Vol 4 (1) ◽  
pp. 21-31 ◽  
Author(s):  
Timothy J. Mader ◽  
Brian H. Nathanson ◽  
William E. Soares ◽  
Ryan A. Coute ◽  
Bryan F. McNally ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Therapeutic Hypothermia ◽  
Comparative Effectiveness ◽  
Large Data ◽  
Data Registry ◽  
Hospital Cardiac Arrest

Improving Survival After In-Hospital Cardiac Arrest: The Australian Experience

2007 ◽  
Vol 16 (3) ◽  
pp. 240-247 ◽  
Author(s):  
Robyn Peters ◽  
Mary Boyde
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Survival Rates ◽  
Spontaneous Circulation ◽  
High Rate ◽  
Hospital Data ◽  
Return Of Spontaneous Circulation ◽  
Shockable Rhythm ◽  
Resuscitation Training ◽  
Hospital Cardiac Arrest

Background Survival rates after in-hospital cardiac arrest have not improved markedly despite improvements in technology and resuscitation training. Objectives To investigate clinical variables that influence return of spontaneous circulation and survival to discharge after in-hospital cardiac arrest. Methods An Utstein-style resuscitation template was implemented in a 750-bed hospital. Data on 158 events were collected from January 2004 through November 2004. Significant variables were analyzed by using a multiple logistic regression model. Results Of the 158 events, 128 were confirmed cardiac arrests. Return of spontaneous circulation occurred in 69 cases (54%), and the patient survived to discharge in 41 (32%). An initial shockable rhythm was present in 42 cases (33%), with a return of spontaneous circulation in 32 (76%) and survival to discharge in 24 (57%). An initial nonshockable rhythm was present in the remaining 86 cases (67%), with a return of spontaneous circulation in 37 (43%) and survival to discharge in 17 (20%). Witnessed or monitored arrests (P=.006), time to arrival of the cardiac arrest team (P=.002), afternoon shift (P=.02), and initial shockable rhythm (P=.005) were independently associated with return of spontaneous circulation. Location of patient in a critical care area (P=.002), initial shockable rhythm (P&lt;.001), and length of resuscitation (P=.02) were independently associated with survival to hospital discharge. Conclusions The high rate of survival to discharge after cardiac arrest is attributed to extensive education and the incorporation of semiautomatic external defibrillators into basic life support management.

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