Survival and variability over time from out of hospital cardiac arrest across large geographically diverse communities participating in the Resuscitation Outcomes Consortium

for the ROC investigators

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The Resuscitation Outcomes Consortium (ROC)epidemiological registry (Epistry) provides opportunities to assess trends in out-of-hospital cardiac arrest treatment and outcomes. Methods: Patient, event, system, treatment, and outcome data from adult (≥18 years) out-of-hospital cardiac arrest (OHCA) from 10 geographically diverse North American ROC sites over four 12-month epochs, from July 1, 2011 to June 30, 2015, were assessed. Descriptive statistics were used to characterize the sample and logistic regression assessed the association of study epoch and key covariates on survival. Results: Overall, 85,553 patients were assessed by Emergency Medical Services (EMS) and 45,516 (53.2%, site range 30.4%–69.9%) had resuscitation attempted by EMS. Patient and event characteristics were consistent except for increases in bystander CPR (41.3%–44.9%) and bystander AED application (3.9%–5.2%). EMS CPR depth and compression fraction increased while pre-shock pause interval decreased. Targeted temperature management was performed in 51.1% of admitted patients and early coronary angiography in 30.2%. Survival to hospital discharge improved (from 10.9% to 11.3% across epochs) with epoch significantly associated with survival (p < 0.001) showing an increasing trend in survival over time. (p = 0.02). Marked site variation in survival persisted within and across epochs (overall site range: 4.2%–19.8%). Patients with an initially shockable rhythm (VT/VF) had an overall survival of 32.2% (site range: 11.9%–47.1%) while survival in bystander witnessed VT/VF was 35.8% (site range: 12.9%–53.1%). Conclusions: Survival from adult OHCA in multiple large geographically-separate sites improved over the study period. Marked site differences in survival persist and addressing this variation is essential to improve outcomes from OHCA across North America.

Original languageEnglish (US)
Pages (from-to)74-82
Number of pages9
JournalResuscitation
Volume131
DOIs
StatePublished - Oct 1 2018

Fingerprint

Out-of-Hospital Cardiac Arrest
Resuscitation
Survival
Emergency Medical Services
Cardiopulmonary Resuscitation
North America
Coronary Angiography
Registries
Shock
Logistic Models
Temperature

Keywords

  • EMS
  • Out-of-hospital-cardiac-arrest
  • Outcomes

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

Cite this

@article{1082787478e24d1b8e079e7fff61f781,
title = "Survival and variability over time from out of hospital cardiac arrest across large geographically diverse communities participating in the Resuscitation Outcomes Consortium",
abstract = "Background: The Resuscitation Outcomes Consortium (ROC)epidemiological registry (Epistry) provides opportunities to assess trends in out-of-hospital cardiac arrest treatment and outcomes. Methods: Patient, event, system, treatment, and outcome data from adult (≥18 years) out-of-hospital cardiac arrest (OHCA) from 10 geographically diverse North American ROC sites over four 12-month epochs, from July 1, 2011 to June 30, 2015, were assessed. Descriptive statistics were used to characterize the sample and logistic regression assessed the association of study epoch and key covariates on survival. Results: Overall, 85,553 patients were assessed by Emergency Medical Services (EMS) and 45,516 (53.2{\%}, site range 30.4{\%}–69.9{\%}) had resuscitation attempted by EMS. Patient and event characteristics were consistent except for increases in bystander CPR (41.3{\%}–44.9{\%}) and bystander AED application (3.9{\%}–5.2{\%}). EMS CPR depth and compression fraction increased while pre-shock pause interval decreased. Targeted temperature management was performed in 51.1{\%} of admitted patients and early coronary angiography in 30.2{\%}. Survival to hospital discharge improved (from 10.9{\%} to 11.3{\%} across epochs) with epoch significantly associated with survival (p < 0.001) showing an increasing trend in survival over time. (p = 0.02). Marked site variation in survival persisted within and across epochs (overall site range: 4.2{\%}–19.8{\%}). Patients with an initially shockable rhythm (VT/VF) had an overall survival of 32.2{\%} (site range: 11.9{\%}–47.1{\%}) while survival in bystander witnessed VT/VF was 35.8{\%} (site range: 12.9{\%}–53.1{\%}). Conclusions: Survival from adult OHCA in multiple large geographically-separate sites improved over the study period. Marked site differences in survival persist and addressing this variation is essential to improve outcomes from OHCA across North America.",
keywords = "EMS, Out-of-hospital-cardiac-arrest, Outcomes",
author = "{for the ROC investigators} and Dana Zive and R. Schmicker and Daya, {Mohamud Ramzan} and P. Kudenchuk and G. Nichol and Rittenberger, {J. C.} and T. Aufderheide and Vilke, {G. M.} and J. Christenson and Buick, {J. E.} and K. Kaila and S. May and T. Rea and Morrison, {L. J.}",
year = "2018",
month = "10",
day = "1",
doi = "10.1016/j.resuscitation.2018.07.023",
language = "English (US)",
volume = "131",
pages = "74--82",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Survival and variability over time from out of hospital cardiac arrest across large geographically diverse communities participating in the Resuscitation Outcomes Consortium

AU - for the ROC investigators

AU - Zive, Dana

AU - Schmicker, R.

AU - Daya, Mohamud Ramzan

AU - Kudenchuk, P.

AU - Nichol, G.

AU - Rittenberger, J. C.

AU - Aufderheide, T.

AU - Vilke, G. M.

AU - Christenson, J.

AU - Buick, J. E.

AU - Kaila, K.

AU - May, S.

AU - Rea, T.

AU - Morrison, L. J.

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Background: The Resuscitation Outcomes Consortium (ROC)epidemiological registry (Epistry) provides opportunities to assess trends in out-of-hospital cardiac arrest treatment and outcomes. Methods: Patient, event, system, treatment, and outcome data from adult (≥18 years) out-of-hospital cardiac arrest (OHCA) from 10 geographically diverse North American ROC sites over four 12-month epochs, from July 1, 2011 to June 30, 2015, were assessed. Descriptive statistics were used to characterize the sample and logistic regression assessed the association of study epoch and key covariates on survival. Results: Overall, 85,553 patients were assessed by Emergency Medical Services (EMS) and 45,516 (53.2%, site range 30.4%–69.9%) had resuscitation attempted by EMS. Patient and event characteristics were consistent except for increases in bystander CPR (41.3%–44.9%) and bystander AED application (3.9%–5.2%). EMS CPR depth and compression fraction increased while pre-shock pause interval decreased. Targeted temperature management was performed in 51.1% of admitted patients and early coronary angiography in 30.2%. Survival to hospital discharge improved (from 10.9% to 11.3% across epochs) with epoch significantly associated with survival (p < 0.001) showing an increasing trend in survival over time. (p = 0.02). Marked site variation in survival persisted within and across epochs (overall site range: 4.2%–19.8%). Patients with an initially shockable rhythm (VT/VF) had an overall survival of 32.2% (site range: 11.9%–47.1%) while survival in bystander witnessed VT/VF was 35.8% (site range: 12.9%–53.1%). Conclusions: Survival from adult OHCA in multiple large geographically-separate sites improved over the study period. Marked site differences in survival persist and addressing this variation is essential to improve outcomes from OHCA across North America.

AB - Background: The Resuscitation Outcomes Consortium (ROC)epidemiological registry (Epistry) provides opportunities to assess trends in out-of-hospital cardiac arrest treatment and outcomes. Methods: Patient, event, system, treatment, and outcome data from adult (≥18 years) out-of-hospital cardiac arrest (OHCA) from 10 geographically diverse North American ROC sites over four 12-month epochs, from July 1, 2011 to June 30, 2015, were assessed. Descriptive statistics were used to characterize the sample and logistic regression assessed the association of study epoch and key covariates on survival. Results: Overall, 85,553 patients were assessed by Emergency Medical Services (EMS) and 45,516 (53.2%, site range 30.4%–69.9%) had resuscitation attempted by EMS. Patient and event characteristics were consistent except for increases in bystander CPR (41.3%–44.9%) and bystander AED application (3.9%–5.2%). EMS CPR depth and compression fraction increased while pre-shock pause interval decreased. Targeted temperature management was performed in 51.1% of admitted patients and early coronary angiography in 30.2%. Survival to hospital discharge improved (from 10.9% to 11.3% across epochs) with epoch significantly associated with survival (p < 0.001) showing an increasing trend in survival over time. (p = 0.02). Marked site variation in survival persisted within and across epochs (overall site range: 4.2%–19.8%). Patients with an initially shockable rhythm (VT/VF) had an overall survival of 32.2% (site range: 11.9%–47.1%) while survival in bystander witnessed VT/VF was 35.8% (site range: 12.9%–53.1%). Conclusions: Survival from adult OHCA in multiple large geographically-separate sites improved over the study period. Marked site differences in survival persist and addressing this variation is essential to improve outcomes from OHCA across North America.

KW - EMS

KW - Out-of-hospital-cardiac-arrest

KW - Outcomes

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U2 - 10.1016/j.resuscitation.2018.07.023

DO - 10.1016/j.resuscitation.2018.07.023

M3 - Article

VL - 131

SP - 74

EP - 82

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -