Purpose Of The Study: To explore whether variation in in-hospital cardiac arrest (IHCA) survival can be explained by differences in resuscitation service provision across UK acute hospitals.
Methods: We linked information on key clinical practices with patient data of adults who had a cardiac arrest on a general hospital ward or emergency admissions unit in 2016/17. We used multi-level Bayesian models to explore associations between system quality indicators (number of resuscitation officers, audits time to first shock, review unexpected non-survivors, arrest team meets at handover, hot debrief, cold debrief, real-time audio-visual feedback, frequency of mock arrest provision) and adjusted hospital survival.
Results: We received survey responses from 110 out of 180 eligible hospitals (response rate 61%) relating to 12,285 cardiac arrest cases. Variation across trusts was observed in the number of resuscitation officers (median 0.7 (interquartile range 0.5, 0.9) per 750 clinical staff employed. Key system quality indicators were undertaken infrequently: audit of time to first shock (44.7%), arrest team meeting at handover (28.9%), mock arrests ≥ monthly (22.4%), and use of CPR feedback devices (18.4%). The probability that the system quality indicators had a positive effect on hospital survival ranged from 10% to 89%. However, there was uncertainty in the estimated odds ratios and we cannot exclude the possibility of a clinical benefit. Findings were consistent across secondary outcomes.
Conclusion: In this study, we identified variation in implementation of system quality indicators. Amongst hospitals that responded to our survey, the probability that individual factors increase the odds of hospital survival ranges from 10 to 89%.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.resuscitation.2020.04.006 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Description of current status of implementation and management of cardiac arrest in China.
Sci Rep
January 2025
Emergency Department, The State Key Laboratory for Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Variation in the incidence, survival rate and factors associated with survival after cardiac arrest in China is reported. Some studies have tried to fill the knowledge gap regarding the epidemiology of cardiac arrest in China but were unable to identify reasons for the reported differences. Therefore, the purpose of this study was to describe Chinese management of cardiac arrest, particularly from the perspective of compression, ventilation, monitoring, treatment, and extracorporeal cardiopulmonary resuscitation.
View Article and Find Full Text PDFTermination of Resuscitation Rules for In-Hospital Cardiac Arrest.
JAMA Intern Med
January 2025
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Importance: There are no validated decision rules for terminating resuscitation during in-hospital cardiac arrest. Decision rules may guide termination and prevent inappropriate early termination of resuscitation.
Objective: To develop and validate termination of resuscitation rules for in-hospital cardiac arrest.
Outcomes of electrical injuries in the emergency department: epidemiology, severity predictors, and chronic sequelae.
Eur J Trauma Emerg Surg
January 2025
Emergency Department, Habib bourguiba university hospital, Faculty of Medicine, Sfax University, Majida Boulila Avenue, Sfax, Tunisia.
Introduction: Electrical injuries (EIs) represent a significant clinical challenge due to their complex pathophysiology and variable presentation, ranging from minor burns to severe internal organ damage. Despite their prevalence in both; domestic and occupational settings, there remains a rareness of systematic guidelines and comprehensive literature to aid clinicians in effectively managing these injuries. Understanding these factors is crucial for developing protocols that can mitigate the risk of delayed complications, such as cardiac arrhythmias, in patients who initially appear stable.
View Article and Find Full Text PDFSodium-glucose cotransporter 2 inhibitors and outcomes in transthyretin amyloid cardiomyopathy: Systematic review and meta-analysis.
Eur J Clin Invest
January 2025
Second Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Background: Transthyretin amyloid cardiomyopathy (ATTR-CM) commonly leads to heart failure but has traditionally been an exclusion criterion in randomized clinical trials (RCTs) of sodium-glucose cotransporter 2 inhibitors (SGLT2i); therefore, the effects of these drugs in this population remain undocumented. In light of recent studies, this meta-analysis aimed to investigate the effect of SGLT2i on the prognosis of patients with ATTR-CM.
Methods: A comprehensive search of Medline, Scopus, and the Cochrane Library was conducted up to November 17, 2024.
Veno-venous extracorporeal membrane oxygenation (VV-ECMO) for acute poisonings in United States: a retrospective analysis of the Extracorporeal Life Support Organization Registry.
Clin Toxicol (Phila)
January 2025
Pediatric Intensive Care Unit, Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Introduction: Veno-arterial extracorporeal membrane oxygenation is frequently considered and implemented to help manage patients with cardiogenic shock from acute poisoning. However, utilization of veno-venous extracorporeal membrane oxygenation in acutely poisoned patients is largely unknown.
Method: We conducted a retrospective study analyzing the epidemiologic, clinical characteristics and survival of acutely poisoned patients placed on veno-venous extracorporeal membrane oxygenation using the Extracorporeal Life Support Organization registry.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!