TY - JOUR
T1 - Long-Term Outcomes for Out-of-Hospital Cardiac Arrest in Elderly Patients
T2 - An Analysis of Cardiac Arrest Registry to Enhance Survival Data Linked to Medicare Files
AU - Chan, Paul S.
AU - McNally, Bryan
AU - Chang, Anping
AU - Girotra, Saket
AU - Al-Araji, Rabab
AU - Mawani, Minaz
AU - Ahn, Ki Ok
AU - Merritt, Robert
N1 - Funding Information:
CARES was funded by the Centers for Disease Control and Prevention from 2004 to 2012. The program is now supported through private funding from the American Red Cross, the American Heart Association, and in-kind support from Emory University. Dr McNally receives grant CARES funding from the American Red Cross and the American Heart Association. Dr Girotra is funded by the National Heart, Lung and Blood Institute (R56HL158803) and also receives funding from the American Heart Association for editorial work.
Publisher Copyright:
© 2022 American Heart Association, Inc.
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Background: Most studies on out-of-hospital cardiac arrest have primarily focused on in-hospital or short-term survival. Little is known about long-term outcomes and resource use among survivors of out-of-hospital cardiac arrest. Methods: In this observationsl study, we describe overall long-term outcomes for patients from the national Cardiac Arrest Registry to Enhance Survival linked to Medicare files to create the Cardiac Arrest Registry to Enhance Survival: Mortality, Events, and Costs for Cardiac Arrest survivors dataset. Cardiac Arrest Registry to Enhance Survival data between 2013 and 2019 were linked to Medicare data using probabilistic matching algorithms. Overall long-term mortality, readmissions, and index hospitalization costs are reported for the overall cohort. Results: Among 56 425 patients who were 65 years of age or older in Cardiac Arrest Registry to Enhance Survival who survived to hospital admission, 26 875 (47.6%) were successfully linked to Medicare files. Mean (+SD) cost of the index hospitalization was $23 262+$24 199 and the median cost was $14 636 (interquartile range, $9930-$30 033). Overall, 8676 (32.3%) survived to hospital discharge with 38.0% discharged home, 11.8% to hospice care, and the remaining 50.2% to other inpatient, skilled nursing care, or rehabilitation facilities. Mortality after discharge was initially high (27.0% at 3 months) and then increased gradually, with 1- and 3-year mortality of 37.1% and 50.1%, respectively. During the first year, 40.1% were readmitted at least once, with 19.7% readmitted on > 1 occasion. Conclusions: The Cardiac Arrest Registry to Enhance Survival: Mortality, Events, and Costs for Cardiac Arrest survivors registry includes rich data on postdischarge outcomes and resource utilization. Use of this dataset will enable future investigations on the long-term effectiveness, costs, and cost-effectiveness of various interventions for out-of-hospital cardiac arrest in elderly patients.
AB - Background: Most studies on out-of-hospital cardiac arrest have primarily focused on in-hospital or short-term survival. Little is known about long-term outcomes and resource use among survivors of out-of-hospital cardiac arrest. Methods: In this observationsl study, we describe overall long-term outcomes for patients from the national Cardiac Arrest Registry to Enhance Survival linked to Medicare files to create the Cardiac Arrest Registry to Enhance Survival: Mortality, Events, and Costs for Cardiac Arrest survivors dataset. Cardiac Arrest Registry to Enhance Survival data between 2013 and 2019 were linked to Medicare data using probabilistic matching algorithms. Overall long-term mortality, readmissions, and index hospitalization costs are reported for the overall cohort. Results: Among 56 425 patients who were 65 years of age or older in Cardiac Arrest Registry to Enhance Survival who survived to hospital admission, 26 875 (47.6%) were successfully linked to Medicare files. Mean (+SD) cost of the index hospitalization was $23 262+$24 199 and the median cost was $14 636 (interquartile range, $9930-$30 033). Overall, 8676 (32.3%) survived to hospital discharge with 38.0% discharged home, 11.8% to hospice care, and the remaining 50.2% to other inpatient, skilled nursing care, or rehabilitation facilities. Mortality after discharge was initially high (27.0% at 3 months) and then increased gradually, with 1- and 3-year mortality of 37.1% and 50.1%, respectively. During the first year, 40.1% were readmitted at least once, with 19.7% readmitted on > 1 occasion. Conclusions: The Cardiac Arrest Registry to Enhance Survival: Mortality, Events, and Costs for Cardiac Arrest survivors registry includes rich data on postdischarge outcomes and resource utilization. Use of this dataset will enable future investigations on the long-term effectiveness, costs, and cost-effectiveness of various interventions for out-of-hospital cardiac arrest in elderly patients.
KW - cardiac arrest
KW - cost
KW - outcomes research
KW - registry
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85138999117&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85138999117&partnerID=8YFLogxK
U2 - 10.1161/CIRCOUTCOMES.122.009042
DO - 10.1161/CIRCOUTCOMES.122.009042
M3 - Article
C2 - 36193751
AN - SCOPUS:85138999117
SN - 1941-7713
VL - 15
JO - Circulation: Cardiovascular Quality and Outcomes
JF - Circulation: Cardiovascular Quality and Outcomes
IS - 10
M1 - e009042
ER -