Admission of out-of-hospital cardiac arrest victims to a high volume cardiac arrest center is linked to improved outcome

Schober, Andreas; Sterz, Fritz; Laggner, Anton N.; Poppe, Michael; Sulzgruber, Patrick; Lobmeyr, Elisabeth; Datler, Philip; Keferböck, Markus; Zeiner, Sebastian; Nuernberger, A.; Eder, Bettina; Hinterholzer, G; Mydza, Daniel; Enzelsberger, Barbara; Herbich, Klaus; Schuster, Reinhard; Koeller, Elke; Publig, T.; Smetana, Peter; Scheibenpflug, Chrisitian; Christ, Günter; Meyer, Brigitte; Uray, Thomas

doi:10.1016/j.resuscitation.2016.06.021

Cited by 61 publications

(43 citation statements)

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“…Patient care may be affected by other healthcare system pressures such as lack of resources or availability. Further considerations should also be given to hospital characteristics such as the number of cardiac arrest cases and other post-resuscitation hospital processes [34,[58][59][60][61]. A substantial challenge remains in identifying those components of post cardiac arrest care provided by a CAC that improve patient outcomes, especially recognizing the spectrum of disease severity across the post cardiac arrest syndrome and potential for tailored bundles of care.From the included studies, the volume and annual case load of cardiac arrest did not improve patientsurvival in either CAC or other hospital setting.…”

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confidence: 99%

Does care at a cardiac arrest centre improve outcome after out-of-hospital cardiac arrest? — A systematic review

et al. 2019

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Please cite this article as: Yeung J, Matsuyama T, Bray J, Reynolds J, Skrifvars MB, Does care at a cardiac arrest centre improve outcome after out-of-hospital cardiac arrest? -A systematic review, Resuscitation (2019), https://doi.on behalf of the Education, Implementation and Team Task Force and Advanced Life Support Task Force of the International Liaison Committee on Resuscitation AIMTo perform a systematic review to answer 'In adults with attempted resuscitation after non-traumatic cardiac arrest does care at a specialised cardiac arrest centre (CAC) compared to care in a healthcare facility not designated as a specialised cardiac arrest centre improve patient outcomes?' METHODSThe PRISMA guidelines were followed. We searched bibliographic databases (Embase, MEDLINE and the Cochrane Library (CENTRAL)) from inception to 1 st August 2018. Randomised controlled trials (RCTs) and non-randomised studies were eligible for inclusion. Two reviewers independently scrutinized studies for relevance, extracted data and assessed quality of studies. Risk of bias of studies and quality of evidence were assessed using ROBINS-I tool and GRADEpro respectively. Primary outcomes were survival to 30 days with favourable neurological outcomes and survival to hospital discharge with favourable neurological outcomes. Secondary outcomes were survival to 30 days, survival to hospital discharge and return of spontaneous circulation (ROSC) post-hospital arrival for patients with ongoing resuscitation. This systematic review was registered in PROSPERO (CRD 42018093369) RESULTSWe included data from 17 observational studies on out-of-hospital cardiac arrest (OHCA) patients in meta-analyses. Overall, the certainty of evidence was very low. Pooling data from only adjusted analyses, care at CAC was not associated with increased likelihood of survival to 30 days with favourable neurological outcome (OR 2.92, 95%CI 0.68 to 12.48) and survival to 30 days (OR 2.14, 95%CI 0.73 to 6.29) compared to care at other hospitals. Whereas patients cared for at CACs had improved survival to hospital discharge with favourable neurological outcomes (OR 2.22, 95%CI 1.74 to 2.84) and survival to hospital discharge (OR 1.85, 95%CI 1.46 to 2.34). CONCLUSIONSVery low certainty of evidence suggests that post-cardiac arrest care at CACs is associated with improved outcomes at hospital discharge. There remains a need for high quality data to fully elucidate the impact of CACs.

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confidence: 99%

Does care at a cardiac arrest centre improve outcome after out-of-hospital cardiac arrest? — A systematic review

et al. 2019

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“…23 Patients receiving prehospital critical care in these studies are therefore more likely to receive early coronary angiography, targeted temperature management and treatment in high volume centres, all of which have been linked to better outcomes. [30][31][32] Finally, the training, experience and governance structure of EMS providers needs to be considered when comparing prehospital critical care and ALS for OHCA. In all full text publications in this review, prehospital critical care is provided by senior specialist physicians and, in one study, also by specially trained critical care paramedics.…”

Section: Discussionmentioning

confidence: 99%

33 Systematic review of the effectiveness of prehospital critical care following out-of-hospital cardiac arrest

Vopelius-Feldt

2017

Emerg Med J

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“…Hospitals with high volumes of CPR cases demonstrate better outcomes for OHCA patients than those with lower volume, despite longer transport times to these cardiac arrest centers. 10,13,16,17,[36][37][38][39] Using California statewide data from 2011, we found that 10% of hospitals are defined as AHA Level I cardiac receiving centers, capable of providing 24-hour PCI and TTM, and meet a minimum volume of OHCA patients. 40 As of 2011, these hospitals treated approximately 25% of the OHCA patients in California.…”

Section: Discussionmentioning

confidence: 99%

67 Variations in Cardiac Arrest Regionalization in California

Chang¹,

Mercer²,

Bosson³

et al. 2017

Annals of Emergency Medicine

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Admission of out-of-hospital cardiac arrest victims to a high volume cardiac arrest center is linked to improved outcome

Cited by 61 publications

References 36 publications

Does care at a cardiac arrest centre improve outcome after out-of-hospital cardiac arrest? — A systematic review

Does care at a cardiac arrest centre improve outcome after out-of-hospital cardiac arrest? — A systematic review

33 Systematic review of the effectiveness of prehospital critical care following out-of-hospital cardiac arrest

67 Variations in Cardiac Arrest Regionalization in California

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