Resuscitation in the Hospital: Circadian Variation of Cardiopulmonary Arrest

Jones-Crawford, Jennifer L.; Parish, David C.; Smith, Beverly A.; Dane, Francis C.

doi:10.1016/j.amjmed.2006.06.032

Cited by 46 publications

(40 citation statements)

References 45 publications

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“…1,3,28,29 In our study, the incidence of in-hospital CPR for IHCA was 2.85 per 1000 admissions, which is consistent with that reported by Ehlenbach et al 1 and Kazaure et al 3 IHCA incidence was lowest in the Midwest and highest in the West. IHCA incidence is a function of both the patient's severity of illness and the institutional response and process of care for treating acutely and chronically ill patients and preventing IHCA.…”

Section: Discussionsupporting

confidence: 91%

“…The Northeast was used as the reference region. Variables included in the regression model were age, sex, race, primary expected payer, weekday versus weekend admission, 29 Elixhauser comorbidities, other clinically relevant comorbidities (smoking, dyslipidemia, known coronary artery disease, family history of coronary artery disease, previous myocardial infarction, previous percutaneous coronary intervention, previous coronary artery bypass grafting, previous cardiac arrest, family history of sudden cardiac death, carotid artery disease, dementia, and atrial fibrillation), primary diagnosis of acute myocardial infarction, initial cardiac arrest rhythm (for the overall cohort), and hospital characteristics (location, bed size, and teaching status). These covariates were selected a priori and represent variables known to influence IHCA survival and overall in-hospital mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Baseline patient characteristics included were demographics (age, sex, race), primary expected payer, weekday versus weekend admission, median household income for the patient's ZIP code, 29 Elixhauser comorbidities as defined by the Agency for Healthcare Research and Quality, other clinically relevant comorbidities (smoking, dyslipidemia, known coronary artery disease, family history of coronary artery disease, previous myocardial infarction, previous percutaneous coronary angioplasty, previous coronary artery bypass grafting, previous cardiac arrest, family history of sudden cardiac death, carotid artery disease, dementia, and atrial fibrillation), primary diagnosis of acute myocardial infarction, and cardiac arrest rhythm. 21,22 A list of ICD-9-CM and Clinical Classifications Software codes used to identify comorbidities is provided in Table I in the online-only Data Supplement.…”

Section: Patient and Hospital Characteristicsmentioning

confidence: 99%

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Regional Variation in the Incidence and Outcomes of In-Hospital Cardiac Arrest in the United States

et al. 2015

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Background— Regional variation in the incidence and outcomes of in-hospital cardiac arrest (IHCA) is not well studied and may have important health and policy implications. Methods and Results— We used the 2003 to 2011 Nationwide Inpatient Sample databases to identify patients ≥18 years of age who underwent cardiopulmonary resuscitation ( International Classification of Diseases, Ninth Edition, Clinical Modification procedure codes 99.60 and 99.63) for IHCA. Regional differences in IHCA incidence, survival to hospital discharge, and resource use (total hospital cost and discharge disposition among survivors) were analyzed. Of 838 465 patients with IHCA, 162 270 (19.4%) were in the Northeast, 159 581 (19.0%) were in the Midwest, 316 201 (37.7%) were in the South, and 200 413 (23.9%) were in the West. Overall IHCA incidence in the United States was 2.85 per 1000 hospital admissions. IHCA incidence was lowest in the Midwest and highest in the West (2.33 and 3.73 per 1000 hospital admissions, respectively). Compared with the Northeast, risk-adjusted survival to discharge was significantly higher in the Midwest (odds ratio, 1.33; 95% confidence interval, 1.31–1.36), South (odds ratio, 1.21; 95% confidence interval, 1.19–1.23), and West (odds ratio, 1.25; 95% confidence interval, 1.23–1.27). IHCA survival increased significantly from 2003 to 2011 in the United States and in all regions (all P trend <0.001). Total hospital cost was highest in the West, whereas discharge to skilled nursing facility and use of home health care among survivors was highest in the Northeast. Conclusions— We observed significant regional variation in IHCA incidence, survival, and resource use in the United States. This variation was explained only partially by differences in patient and hospital characteristics. Further studies are needed to identify other potential factors responsible for these regional differences to improve outcomes after IHCA.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Patient and Hospital Characteristicsmentioning

confidence: 99%

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Regional Variation in the Incidence and Outcomes of In-Hospital Cardiac Arrest in the United States

et al. 2015

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“…Single-institution studies using Utstein criteria have reported large variations in hospital-wide incidence rates of adult IHCA, ranging from 3.8 to 13.1 per 1000 admissions. 7,8 A systematic review and meta-analysis of rapid response systems within 41 hospitals (academic and community) involving >1 million admissions described an incidence of IHCA occurring outside of ICUs of 3.66 per 1000 adult admissions and 1.14 per 1000 pediatric admissions. 9 Because 45% of adult arrests and 65% of pediatric arrests occur in ICUs, 10 by extrapolation, the hospital-wide rate of cardiac arrests is likely to be closer to 6.65 and 3.26 per 1000 admissions for adults and children, respectively.…”

Section: Published Estimates Of Incidencementioning

confidence: 99%

Strategies for Improving Survival After In-Hospital Cardiac Arrest in the United States: 2013 Consensus Recommendations

Morrison¹,

Neumar²,

Zimmerman³

et al. 2013

Circulation

266

182

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“…In the US and Canada, approximately 350 000 people/year (approximately half of them in-hospital) suffer a cardiac arrest and receive attempted resuscitation. [3][4][5][6][7] This estimate does not include the substantial number of victims who suffer an arrest without attempted resuscitation. While attempted resuscitation is not always appropriate, there are many lives and life-years lost because appropriate resuscitation is not attempted.…”

Section: Epidemiologymentioning

confidence: 99%