dc.contributor.author | May, Teresa L. | |
dc.contributor.author | Lary, Christine W. | |
dc.contributor.author | Riker, Richard R. | |
dc.contributor.author | Friberg, Hans | |
dc.contributor.author | Patel, Nainesh | |
dc.contributor.author | Søreide, Eldar | |
dc.contributor.author | McPherson, John A. | |
dc.contributor.author | Undén, Johan | |
dc.contributor.author | Hand, Robert | |
dc.contributor.author | Sunde, Kjetil | |
dc.contributor.author | Stammet, Pascal | |
dc.contributor.author | Rubertsson, Stein | |
dc.contributor.author | Belohlvaek, Jan | |
dc.contributor.author | Dupont, Allison | |
dc.contributor.author | Hirsch, Karen G. | |
dc.contributor.author | Valsson, Felix | |
dc.contributor.author | Kern, Karl | |
dc.contributor.author | Sadaka, Farid | |
dc.contributor.author | Israelsson, Johan | |
dc.contributor.author | Dankiewicz, Josef | |
dc.contributor.author | Nielsen, Niklas | |
dc.contributor.author | Seder, David B. | |
dc.contributor.author | Agarwal, Sachin | |
dc.date.accessioned | 2021-04-20T11:32:47Z | |
dc.date.available | 2021-04-20T11:32:47Z | |
dc.date.created | 2019-06-30T12:12:11Z | |
dc.date.issued | 2019 | |
dc.Published | Intensive Care Medicine. 2019, 45 (5), 637-646. | |
dc.identifier.issn | 0342-4642 | |
dc.identifier.uri | https://hdl.handle.net/11250/2738645 | |
dc.description.abstract | Purpose
Functional outcomes vary between centers after out-of-hospital cardiac arrest (OHCA) and are partially explained by pre-existing health status and arrest characteristics, while the effects of in-hospital treatments on functional outcome are less understood. We examined variation in functional outcomes by center after adjusting for patient- and arrest-specific characteristics and evaluated how in-hospital management differs between high- and low-performing centers.
Methods
Analysis of observational registry data within the International Cardiac Arrest Registry was used to perform a hierarchical model of center-specific risk standardized rates for good outcome, adjusted for demographics, pre-existing functional status, and arrest-related factors with treatment center as a random effect variable. We described the variability in treatments and diagnostic tests that may influence outcome at centers with adjusted rates significantly above and below registry average.
Results
A total of 3855 patients were admitted to an ICU following cardiac arrest with return of spontaneous circulation. The overall prevalence of good outcome was 11–63% among centers. After adjustment, center-specific risk standardized rates for good functional outcome ranged from 0.47 (0.37–0.58) to 0.20 (0.12–0.26). High-performing centers had faster time to goal temperature, were more likely to have goal temperature of 33 °C, more likely to perform unconscious cardiac catheterization and percutaneous coronary intervention, and had differing prognostication practices than low-performing centers.
Conclusions
Center-specific differences in outcomes after OHCA after adjusting for patient-specific factors exist. This variation could partially be explained by in-hospital management differences. Future research should address the contribution of these factors to the differences in outcomes after resuscitation. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Springer | en_US |
dc.title | Variability in functional outcome and treatment practices by treatment center after out-of-hospital cardiac arrest: analysis of International Cardiac Arrest Registry | en_US |
dc.type | Journal article | en_US |
dc.type | Peer reviewed | en_US |
dc.description.version | acceptedVersion | en_US |
dc.rights.holder | Copyright 2019 Springer | en_US |
cristin.ispublished | true | |
cristin.fulltext | postprint | |
cristin.qualitycode | 1 | |
dc.identifier.doi | 10.1007/s00134-019-05580-7 | |
dc.identifier.cristin | 1708858 | |
dc.source.journal | Intensive Care Medicine | en_US |
dc.source.40 | 45 | |
dc.source.14 | 5 | |
dc.source.pagenumber | 637-646 | en_US |
dc.identifier.citation | Intensive Care Medicine. 2019, 45, 637–646 | en_US |
dc.source.volume | 45 | en_US |