TY - JOUR
T1 - Out-of-hospital cardiac arrest survival improving over time
T2 - Results from the Resuscitation Outcomes Consortium (ROC)
AU - Resuscitation Outcomes Consortium Investigators
AU - Daya, Mohamud R.
AU - Schmicker, Robert H.
AU - Zive, Dana M.
AU - Rea, Thomas D.
AU - Nichol, Graham
AU - Buick, Jason E.
AU - Brooks, Steven
AU - Christenson, Jim
AU - MacPhee, Renee
AU - Craig, Alan
AU - Rittenberger, Jon C.
AU - Davis, Daniel P.
AU - May, Susanne
AU - Wigginton, Jane
AU - Wang, Henry
N1 - 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:
© 2015 Elsevier Ireland Ltd.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Background: Out-of-hospital cardiac arrest (OHCA) remains a leading cause of death and a 2010 meta-analysis concluded that outcomes have not improved over several decades. However, guidelines have changed to emphasize CPR quality, minimization of interruptions, and standardized post-resuscitation care. We sought to evaluate whether OHCA outcomes have improved over time among agencies participating in the Resuscitation Outcomes Consortium (ROC) cardiac arrest registry (Epistry) and randomized clinical trials (RCTs). Methods: Observational cohort study of 47,148 EMS-treated OHCA cases in Epistry from 139 EMS agencies at 10 ROC sites that participated in at least one RCT between 1/1/2006 and 12/31/2010. We reviewed patient, scene, event characteristics, and outcomes of EMS-treated OHCA over time, including subgroups with initial rhythm of pulseless ventricular tachycardia or ventricular fibrillation (VT/VF). Results: Mean response interval, median age and male proportion remained similar over time. Unadjusted survival to discharge increased between 2006 and 2010 for treated OHCA (from 8.2% to 10.4%), as well as for subgroups of VT/VF (21.4% to 29.3%) and bystander witnessed VT/VF (23.5% to 30.3%). Compared with 2006, adjusted survival to discharge was significantly higher in 2010 for treated cases (OR. =. 1.72; 95% CI 1.53, 1.94), VT/VF cases (OR. =. 1.69; 95% CI 1.45, 1.98) and bystander witnessed VT/VF cases (OR. =. 1.65; 95% CI 1.36, 2.00). Tests for trend in each subgroup were significant (. p<. 0.001). Conclusions: ROC-wide survival increased significantly between 2006 and 2010. Additional research efforts are warranted to identify specific factors associated with this improvement.
AB - Background: Out-of-hospital cardiac arrest (OHCA) remains a leading cause of death and a 2010 meta-analysis concluded that outcomes have not improved over several decades. However, guidelines have changed to emphasize CPR quality, minimization of interruptions, and standardized post-resuscitation care. We sought to evaluate whether OHCA outcomes have improved over time among agencies participating in the Resuscitation Outcomes Consortium (ROC) cardiac arrest registry (Epistry) and randomized clinical trials (RCTs). Methods: Observational cohort study of 47,148 EMS-treated OHCA cases in Epistry from 139 EMS agencies at 10 ROC sites that participated in at least one RCT between 1/1/2006 and 12/31/2010. We reviewed patient, scene, event characteristics, and outcomes of EMS-treated OHCA over time, including subgroups with initial rhythm of pulseless ventricular tachycardia or ventricular fibrillation (VT/VF). Results: Mean response interval, median age and male proportion remained similar over time. Unadjusted survival to discharge increased between 2006 and 2010 for treated OHCA (from 8.2% to 10.4%), as well as for subgroups of VT/VF (21.4% to 29.3%) and bystander witnessed VT/VF (23.5% to 30.3%). Compared with 2006, adjusted survival to discharge was significantly higher in 2010 for treated cases (OR. =. 1.72; 95% CI 1.53, 1.94), VT/VF cases (OR. =. 1.69; 95% CI 1.45, 1.98) and bystander witnessed VT/VF cases (OR. =. 1.65; 95% CI 1.36, 2.00). Tests for trend in each subgroup were significant (. p<. 0.001). Conclusions: ROC-wide survival increased significantly between 2006 and 2010. Additional research efforts are warranted to identify specific factors associated with this improvement.
KW - Emergency Medical Services (EMS)
KW - Out-of-hospital cardiac arrest (OHCA)
KW - Resucitation
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U2 - 10.1016/j.resuscitation.2015.02.003
DO - 10.1016/j.resuscitation.2015.02.003
M3 - Article
C2 - 25676321
AN - SCOPUS:84929276591
SN - 0300-9572
VL - 91
SP - 108
EP - 115
JO - Resuscitation
JF - Resuscitation
ER -