Recommended guidelines for reviewing, reporting, and conducting research on in-hospital resuscitation: the in-hospital ‘Utstein style’

Cummins, Richard O.; Chamberlain, Douglas; Hazinski, Mary Fran; Nadkarni, Vinay; Kloeck, Walter; Kramer, Efraim; Becker, Lance B.; Robertson, Colin E.; Koster, R. W.; Zaritsky, Arno; Bossaert, Leo; Ornato, Joseph P.; Callanan, V.; Allen, M.; Steen, Petter Andreas; Connolly, Brian; Sanders, Arthur B.; Idris, Ahamed H.; Cobbe, Stuart M.

doi:10.1016/s0300-9572(97)01112-x

Cited by 262 publications

(23 citation statements)

References 175 publications

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“…However, this lack of a standardised approach to reporting is a problem, and is in marked contrast to the approach recommended for other aspects of resuscitation reporting. 41 We are now in an era of intervention in resuscitation research and of financial frugality more generally, thus such a standardised approach, which might include data designed to inform a health economic evaluation, is urgently needed.…”

Section: Discussionmentioning

confidence: 99%

“…The International Liaison Committee on Resuscitation recommends documenting the CPC at discharge from hospital, 6 months and 1 year post cardiac arrest (for those that survive to discharge) 41 ; it makes no further recommendation regarding detailed QoL assessments in these patients. The 'Cerebral Performance Category' is a very gross functional score, but is very easy and simple to use and obtain and undoubtedly provides some useful information.…”

Section: Discussionmentioning

confidence: 99%

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Systematic review of quality of life and other patient-centred outcomes after cardiac arrest survival

2011

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Systematic review of quality of life and other patient-centred outcomes after cardiac arrest survival

2011

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“…A data-gathering form, based on the Utstein model, 8,9 was com- For the primary aim of this study, the frequency of cardiac arrest was defined as the number of occurrences of this adverse event divided by the total number of anesthetic procedures performed in the hospital over the period considered. From the anesthesia records and the data-gathering form, the causes of cardiac arrest and death were retrospectively assigned by three of the present authors as one of the following: entirely related to anesthesia when anesthesia was the only or the major contributory factor; partially related to anesthesia when the patient's disease/condition or the surgical procedure was a contributory factor, but anesthesia represented an additional factor; entirely related to surgery; or entirely related to the patient's disease/condition.…”

Section: Intervention and Outcomementioning

confidence: 99%

Frequency of intraoperative cardiac arrest and medium-term survival

et al. 2013

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CONTEXT AND OBJECTIVE: Although advances in surgical and anesthetic techniques have reduced perioperative morbidity-mortality, the survival rate following cardiac arrest remains low. The aim of this study was to evaluate, over the course of one year, the prevalence of intraoperative cardiac arrest and the 30-day survival rate after this event in a tertiary teaching hospital. DESIGN AND SETTING: Prospective cohort study in a tertiary teaching hospital. METHODS: Following approval by the institutional ethics committee, anesthetic procedures and cases of intraoperative cardiac arrest between January and December 2007 were evaluated. Patients undergoing cardiac surgery were excluded. The data were gathered prospectively using the modified Utstein model, with evaluation of demographic data, pre-arrest conditions, intraoperative care, care during arrest and postoperative outcome up to the 30 th day. The data were recorded by the attending anesthesiologist. RESULTS: During the study period, 40,379 anesthetic procedures were performed, and 52 cases of intraoperative cardiac arrest occurred (frequency of 13:10,000). Among these, 69% presented spontaneous return of circulation after the initial arrest, and only 25% survived for 30 days after the event. The following factors were associated with shorter survival: American Society of Anesthesiologists physical status IV and V, emergency surgery, hemorrhagic events, hypovolemia as the cause of arrest and use of atropine during resuscitation. CONCLUSIONS: Although the frequency of cardiac arrest in the surgical environment has declined and resources to attend to this exist, the survival rate is low. Factors associated with worst prognosis are more frequent in critical patients. RESUMOCONTEXTO E OBJETIVO: Apesar de avanços nas técnicas cirúrgicas e anestésicas terem reduzido a morbimortalidade perioperatória, a taxa de sobrevivência após parada cardíaca (PC) permanece baixa. O objetivo deste estudo foi avaliar, ao longo de um ano, a incidência de PC intraoperatória e de sobrevida por 30 dias após esse evento em um hospital terciário de ensino.

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“…This study is limited by the fact we were not able to provide data of the resuscitation process and the cause of cardiac arrest according to Utstein criteria [28], because the ASDI database was not conducted as a cardiac-arrest registry. Conversely, the size of the database allowed detailed comparisons of in-hospital treatment factors in this cohort.…”

Section: Discussionmentioning

confidence: 99%

Effect of intensive care after cardiac arrest on patient outcome: a database analysis

et al. 2014

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IntroductionThe study aimed to determine the impact of treatment frequency, hospital size, and capability on mortality of patients admitted after cardiac arrest for postresuscitation care to different intensive care units.MethodsProspectively recorded data from 242,588 adults consecutively admitted to 87 Austrian intensive care units over a period of 13 years (1998 to 2010) were analyzed retrospectively. Multivariate analysis was used to assess the effect of the frequency of postresuscitation care on mortality, correcting for baseline parameters, severity of illness, hospital size, and capability to perform coronary angiography and intervention.ResultsIn total, 5,857 patients had had cardiac arrest and were admitted to an intensive care unit. Observed hospital mortality was 56% in the cardiac-arrest cohort (3,302 nonsurvivors). Patients treated in intensive care units with a high frequency of postresuscitation care generally had high severity of illness (median Simplified Acute Physiology Score (SAPS II), 65). Intensive care units with a higher frequency of care showed improved risk-adjusted mortality. The SAPS II adjusted, observed-to-expected mortality ratios (O/E-Ratios) in the three strata (<18; 18 to 26; >26 resuscitations per ICU per year) were 0.869 (95% confidence interval, 0.844 to 894), 0.876 (0.850 to 0.902), and 0.808 (0.784 to 0.833).ConclusionsIn this database analysis, a high frequency of post-cardiac arrest care at an intensive care unit seemed to be associated with improved outcome of cardiac-arrest patients. We were able to identify patients who seemed to profit more from high frequency of care, namely, those with an intermediate severity of illness. Considering these findings, cardiac-arrest care centers might be a reasonable step to improve outcome in this specific population of cardiac-arrest patients.

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Recommended guidelines for reviewing, reporting, and conducting research on in-hospital resuscitation: the in-hospital ‘Utstein style’

Cited by 262 publications

References 175 publications

Systematic review of quality of life and other patient-centred outcomes after cardiac arrest survival

Systematic review of quality of life and other patient-centred outcomes after cardiac arrest survival

Frequency of intraoperative cardiac arrest and medium-term survival

Effect of intensive care after cardiac arrest on patient outcome: a database analysis

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