@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 Zive, {D. M.} and R. Schmicker and M. Daya 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.}",
note = "Funding Information: The ROC is supported by a series of cooperative agreements to nine regional clinical centers and one Data Coordinating Center (5U01 HL077863 – University of Washington Data Coordinating Center , HL077866 – Medical College of Wisconsin , HL077867 – University of Washington , HL077871 – University of Pittsburgh , HL077872 – St. Michael's Hospital , HL077873 – Oregon Health and Science University , HL077881 – University of Alabama at Birmingham , HL077885 – Ottawa Hospital Research Institute , HL077887 – University of Texas SW Medical Center/Dallas , HL077908 – University of California San Diego ) from the National Heart, Lung and Blood Institute in partnership with the National Institute of Neurological Disorders and Stroke, U.S. Army Medical Research & Material Command, The Canadian Institutes of Health Research (CIHR) – Institute of Circulatory and Respiratory Health, Defence Research and Development Canada and the Heart, Stroke Foundation of Canada and the American Heart Association. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung and Blood Institute or the National Institutes of Health. Funding Information: The ROC is supported by a series of cooperative agreements to nine regional clinical centers and one Data Coordinating Center (5U01 HL077863 – University of Washington Data Coordinating Center, HL077866 – Medical College of Wisconsin, HL077867 – University of Washington, HL077871 – University of Pittsburgh, HL077872 – St. Michael's Hospital, HL077873 – Oregon Health and Science University, HL077881 – University of Alabama at Birmingham, HL077885 – Ottawa Hospital Research Institute, HL077887 – University of Texas SW Medical Center/Dallas, HL077908 – University of California San Diego) from the National Heart, Lung and Blood Institute in partnership with the National Institute of Neurological Disorders and Stroke, U.S. Army Medical Research & Material Command, The Canadian Institutes of Health Research (CIHR) – Institute of Circulatory and Respiratory Health, Defence Research and Development Canada and the Heart, Stroke Foundation of Canada and the American Heart Association. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung and Blood Institute or the National Institutes of Health. Publisher Copyright: {\textcopyright} 2018 Elsevier B.V.",
year = "2018",
month = oct,
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",
}