Association of High-Volume Centers With Survival Outcomes Among Patients With Nontraumatic Out-of-Hospital Cardiac Arrest

Abstract

Key Points Question Is treatment at a high-volume center associated with improved survival and neurological outcomes among adult patients with nontraumatic out-of-hospital cardiac arrest (OHCA)? Findings In this systematic review and meta-analysis of 16 articles involving 82 769 patients with OHCA, survival to discharge or 30 days improved with treatment at a high-volume center; there was no association between center volume and good neurological outcomes at 30 days or at hospital discharge. Meaning These findings suggest that treatment at a high-volume center may improve survival but not neurological outcomes in patients with OHCA; more studies evaluating the relative importance of center volume compared with other variables associated with survival outcomes in these patients are required.

Incidence and Long‐Term Outcomes of Acute Myocardial Infarction Among Survivors of Out‐of‐Hospital Cardiac Arrest

“…We included for follow‐up both patients with OHCA who survived to 30 days or who survived to hospital discharge regardless of time from index event, since using either time point reflects up to 99.6% similarity in long‐term survival rates and is an approach previously used in published studies. 20 , 21 All follow‐up periods and incidence of AMI outcomes were calculated from the baseline of either 30 days or discharge after OHCA, depending on whichever time point was earlier for each patient. We applied the following exclusion criteria: patients who were (1) foreigners, (2) aged <18 years, or (3) pronounced dead on the scene or at the emergency department.…”

Diagnosis, severity stratification and management of adult acute pancreatitis–current evidence and controversies

“…Even for oncological surgeries, “high-volume” has been variable, with studies reporting 20-35 cases annually as cut-off for pancreas resection[ 89 , 90 ]. In contrary, studies which reported on outcomes of out-of-hospital cardiac arrest defined high-volume as ≥ 40-100 cases annually[ 91 ]. For AP, there is no literature on what defines “high-volume”.…”

Author Response Letter: “Correspondence: Is there an association between centre volume and survival or neurological outcomes among out-of-hospital cardiac arrest patients?”

“…One major reason for the inconclusive results on this topic may be the varying degrees of centralization of hospital functions in different countries. Thus, recent systematic reviews and meta-analyses have also not reached certain conclusions [ 4 , 5 ]. In fact, the heterogeneity of studies used in these systematic reviews and meta-analyses is high.…”