TY - JOUR
T1 - Long-Term Survival Trends of Medicare Patients After In-Hospital Cardiac Arrest
T2 - Insights from Get With The Guidelines-Resuscitation®
AU - for the American Heart Association's Get With The Guidelines-Resuscitation Investigators
AU - Thompson, Lauren E.
AU - Chan, Paul S.
AU - Tang, Fengming
AU - Nallamothu, Brahmajee K.
AU - Girotra, Saket
AU - Perman, Sarah M.
AU - Bose, Somnath
AU - Daugherty, Stacie L.
AU - Bradley, Steven M.
N1 - Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2018/2
Y1 - 2018/2
N2 - Background Although rates of survival to hospital discharge after in-hospital cardiac arrest (IHCA) have improved over the last decade, it is unknown if these survival gains are sustained after hospital discharge. Objective To examine 1-year survival trends overall and by rhythm after IHCA. Methods Using Medicare beneficiaries (age ≥ 65 years) with IHCA occurring between 2000 and 2011 at Get With The Guidelines®-Resuscitation Registry participating hospitals we used multivariable regression, to examine temporal trends in risk-adjusted rates of 1-year survival. Results Among 45,567 patients with IHCA, the unadjusted 1-year survival was 9.4%. Unadjusted 1-year survival was 21.8% among the 9,223 (20.2%) of patients with Ventricular Fibrillation or Pulseless Ventricular Tachycardia (VF/VT) and 6.2% among the 36,344 (79.8%) of patients with Pulseless Electrical Activity or asystole (PEA/asystole). After adjustment for patient and arrest characteristics, 1-year survival increased over time for all IHCA from 8.9% in 2000–2001 to 15.2% in 2011 (adjusted rate ratio [RR] per year, 1.05; 95% CI, 1.03–1.06; P < 0.001 for trend). Improvements in 1-year risk adjusted survival were also observed for VF/VT (19.4% in 2000–2001 to 25.6% in 2011 [RR per year, 1.02; 95% CI, 1.01–1.04; P 0.004 for trend]) and PEA/asystole arrests (4.7% in 2000–2001 to 10.2% in 2011 [RR per year, 1.07; 95% CI, 1.05–1.08; P < 0.001 for trend]). Conclusion Among Medicare beneficiaries in the GWTG-Resuscitation registry, 1-year survival after IHCA has increased for over the past decade. Temporal improvements in survival were noted for both shockable and non-shockable presenting arrest rhythms.
AB - Background Although rates of survival to hospital discharge after in-hospital cardiac arrest (IHCA) have improved over the last decade, it is unknown if these survival gains are sustained after hospital discharge. Objective To examine 1-year survival trends overall and by rhythm after IHCA. Methods Using Medicare beneficiaries (age ≥ 65 years) with IHCA occurring between 2000 and 2011 at Get With The Guidelines®-Resuscitation Registry participating hospitals we used multivariable regression, to examine temporal trends in risk-adjusted rates of 1-year survival. Results Among 45,567 patients with IHCA, the unadjusted 1-year survival was 9.4%. Unadjusted 1-year survival was 21.8% among the 9,223 (20.2%) of patients with Ventricular Fibrillation or Pulseless Ventricular Tachycardia (VF/VT) and 6.2% among the 36,344 (79.8%) of patients with Pulseless Electrical Activity or asystole (PEA/asystole). After adjustment for patient and arrest characteristics, 1-year survival increased over time for all IHCA from 8.9% in 2000–2001 to 15.2% in 2011 (adjusted rate ratio [RR] per year, 1.05; 95% CI, 1.03–1.06; P < 0.001 for trend). Improvements in 1-year risk adjusted survival were also observed for VF/VT (19.4% in 2000–2001 to 25.6% in 2011 [RR per year, 1.02; 95% CI, 1.01–1.04; P 0.004 for trend]) and PEA/asystole arrests (4.7% in 2000–2001 to 10.2% in 2011 [RR per year, 1.07; 95% CI, 1.05–1.08; P < 0.001 for trend]). Conclusion Among Medicare beneficiaries in the GWTG-Resuscitation registry, 1-year survival after IHCA has increased for over the past decade. Temporal improvements in survival were noted for both shockable and non-shockable presenting arrest rhythms.
KW - In-Hospital cardiac arrest
KW - Outcomes
KW - Resuscitation
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85038227128&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85038227128&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2017.10.023
DO - 10.1016/j.resuscitation.2017.10.023
M3 - Article
C2 - 29102470
AN - SCOPUS:85038227128
SN - 0300-9572
VL - 123
SP - 58
EP - 64
JO - Resuscitation
JF - Resuscitation
ER -