Patients more likely to survive in-hospital cardiac arrest today, study finds
Researchers say clear guidelines have helped.
(HealthDay)—A new study finds that survival after in-hospital cardiac arrest improved substantially from 2000 to 2009 in U.S. medical centers, probably because established guidelines were followed.
On average, people having a cardiac arrest—when the heart stops beating—in a hospital have about a 22 percent chance of surviving at least long enough to go home. Ten years ago, they had less than a 14 percent chance of surviving until discharge, the researchers noted.
Also, the rate of neurologic disability among survivors, including motor weakness or difficulty talking, has decreased. Such problems are often associated with insufficient oxygen reaching the brain during the cardiac arrest and resuscitation efforts.
"We found that survival improved among adult hospital patients for two reasons: People are doing a better job of resuscitation, and they're also getting better at providing care for the patient after resuscitation," said Dr. Saket Girotra, of the division of cardiovascular disease at the University of Iowa Hospitals and Clinics, in Iowa City.
Whether or not people will survive cardiac arrest—when their heart stops beating—depends on a wide variety of factors. Some are related to the individual, such as their age and condition. Other issues are more hospital-related, including: How soon was the patient found? Who arrived at the scene and how soon was cardiopulmonary resuscitation (CPR) started? Was it a weekend? And, for survivors, did interrupted oxygen to the brain cause neurological problems, such as motor weakness or difficulty talking?
The American Heart Association, which funded the study, has developed guidelines for hospitals in an effort to improve the quality of care associated with in-hospital cardiac arrest. Called "Get with the Guidelines - Resuscitation," they offer clear benchmarks to use in training staff to respond to cardiac crises. Experts say application of the guidelines may have improved survival numbers in hospitals.
"This study shows that when you follow quality and you benchmark people you can improve performance," said Dr. Ralph Sacco, a past president of the American Heart Association and chairman of neurology at the University of Miami Miller School of Medicine, in Florida.
Data for the research was taken from a national quality-improvement registry that includes all hospitalized patients with a confirmed cardiac arrest who have received CPR in participating hospitals.
For this study, records for more than 84,600 patients aged 18 or older from 374 hospitals were included, adjusting for myriad factors, Girotra said, including age, sex, race and the presence of other conditions. Patients were excluded if their cardiac arrests occurred in operating rooms, procedural suites, labor and delivery, or emergency departments.
The study authors estimate that given the improved rate of survival they found, an additional 17,200 patients survived to hospital discharge in 2009 as compared with 2000. The rate of surviving the resuscitation attempt but not surviving the hospital stay was about 54 percent, up from nearly 43 percent in 2000.
Another research team examined information on Medicare patients who had CPR after in-hospital cardiac arrest from 1992 through 2005 and found no difference in survival rates to discharge. Girotra said those results, published in the New England Journal of Medicine in 2009, were likely affected by the fact that the researchers used data from administrative claims that may have included patients who hadn't had cardiac arrests or excluded those without the proper billing procedure code.
Sacco hopes researchers will now evaluate how to improve the outcomes of cardiac arrests that occur in public places. "Improving resuscitation after cardiac arrest is one of the big goals of the AHA," he said.
Girotra said this study is "a small step in trying to understand survival." He added that research is needed to better define what factors have the greatest impact on survival by actually visiting facilities and conducting in-depth interviews.
"When there's a cardiac arrest, somebody's really trying to die right in front of you," said Girotra. "Effective resuscitation really involves a team to perform steps in a coordinated fashion, and these factors differ by hospital. We need to identify what are some of these factors that will help us understand how resuscitation care is organized and what will improve quality so we can better educate physicians and staff."
More information: Learn about the "Get with the Guidelines - Resuscitation" program at the American Heart Association.
Journal reference: New England Journal of Medicine
Copyright © 2012 HealthDay. All rights reserved.
- 200,000 patients treated for cardiac arrest annually in US hospitals, study shows Jun 24, 2011 | not rated yet | 0
- Longer resuscitation attempts could improve survival after in-hospital cardiac arrest Sep 04, 2012 | not rated yet | 0
- Adrenaline use in cardiac arrest Jul 26, 2011 | not rated yet | 0
- Survival predictors of cardiac arrest in the ICU Aug 15, 2011 | not rated yet | 0
- Guidelines-based CPR saves more non-shockable cardiac arrest victims Apr 02, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Assumptions of Griffith's fracture theory
7 hours ago Any experts on Griffith's fracture theory? I am studying the subject and I am having hard time finding out if the theory is valid for all possible...
Current leading voltage or vice versa concept
8 hours ago Hello, I was wondering if there is a conceptual explanation for when current leads voltage or vice versa for capacitors or inductors with AC...
Angular Frequency of AC voltage
11 hours ago Hello, I am wondering, what is the physical interpretation of the angular frequency of AC voltage? I don't see the physicality of what the angle...
Modeling Rigid Body - Unsure about Euler angles and angular velocity
11 hours ago I'm modeling a single 3D rigid body in preparation for some more complicated modeling in order to gain a better understanding of Euler angles, the...
Function for a bullet's path
13 hours ago I've been mulling this over all weekend, and I've decided to get some help on this. The problem is writing a function to describe a bullet's path....
Elementary questions relating to Newton's laws of motion
14 hours ago i) If a wall breaks when it gets hit by a cannonball, did the wall exert an equal and opposite force on the cannonball? ii) Would the force...
- More from Physics Forums - Classical Physics
More news stories
(Medical Xpress)—In a recent subgroup analysis of the largest blood pressure treatment trial in history, University of Alabama at Birmingham (UAB) researchers found that women and men react the same to ...
Cardiology 1 hour ago | 5 / 5 (1) | 0
Over the past few decades, scientists have developed many devices that can reopen clogged arteries, including angioplasty balloons and metallic stents. While generally effective, each of these treatments ...
Cardiology 2 hours ago | 5 / 5 (1) | 0 |
(Medical Xpress)—Cardiologists have identified a trio of biomarkers that may predict which patients with heart disease have a high risk of heart attack or death in the next two years.
Cardiology 3 hours ago | not rated yet | 0 |
Hospitals with the highest rates of cardiac arrests tend to have the poorest survival rates for those cases, new University of Michigan Health System research shows.
Cardiology 17 hours ago | not rated yet | 0
A clinical trial of 75 patients hospitalized with acute decompensated heart failure (ADHF) suggests that aggressive fluid and sodium restriction has no effect on weight loss or clinical stability at three days but was associated ...
Cardiology 17 hours ago | not rated yet | 0
In a remote fishing community in Venezuela, a lone fisherman sits on a cliff overlooking the southern Caribbean Sea. This man –– the lookout –– is responsible for directing his comrades on the water, ...
11 minutes ago | not rated yet | 0 |
A novel approach to obstructing the runaway inflammatory response implicated in some types of asthma has shown promise in a Phase IIa clinical trial, according to U. S. researchers.
5 minutes ago | not rated yet | 0
Authorities are investigating rice mills in southern China following tests that found almost half of the staple grain in one of the country's largest cities was contaminated with a toxic metal.
11 minutes ago | not rated yet | 0
Scientists from Nanyang Technological University (NTU) and Lund University, Sweden, have bioengineered a novel molecule which has been proven to successfully kill tumour cells.
20 minutes ago | not rated yet | 0
Regardless of pain, social class or age, a woman is more likely to be prescribed pain-relieving drugs. A study published in Gaceta Sanitaria (Spanish health scientific journal) affirms that this phenomenon is inf ...
30 minutes ago | not rated yet | 0