@article{10b1874752fa4e85b80bb6e523e00063,
title = "Outcomes of in-hospital cardiac arrest among hospitals with and without telemedicine critical care",
abstract = "Background: Survival rates following in-hospital cardiac arrest (IHCA) are lower during nights and weekends (off-hours), as compared to daytime on weekdays (on-hours). Telemedicine Critical Care (TCC) may provide clinical support to improve IHCA outcomes, particularly during off-hours. Objective: To evaluate the association between hospital availability of TCC and IHCA survival. Methods: We identified 44,585 adults at 280 U.S. hospitals in the Get With The Guidelines{\textregistered} - Resuscitation registry who suffered IHCA in an Intensive Care Unit (ICU) or hospital ward between July 2017 and December 2019. We used 2-level hierarchical multivariable logistic regression to investigate whether TCC availability was associated with better survival, overall, and during on-hours (Monday–Friday 7:00 a.m.-10:59p.m.) vs. off-hours (Monday–Friday 11:00p.m.-6:59 a.m., and Saturday-Sunday, all day, and US national holidays). Results: 14,373 (32.2%) participants suffered IHCA at hospitals with TCC, and 27,032 (60.6%) occurred in an ICU. There was no difference between TCC and non-TCC hospitals in acute resuscitation survival rate or survival to discharge rates for either IHCA occurring in the ICU (acute survival odds ratio [OR] 1.02, 95% CI 0.92–1.15; survival to discharge OR 0.94 [0.83–1.07]) or outside of the ICU (acute survival OR 1.03 [0.91–1.17]; survival to discharge OR 0.99 [0.86–1.12]. Timing of cardiac arrest did not modify the association between TCC availability and acute resuscitation survival (P =.37 for interaction) or survival to discharge (P =.39 for interaction). Conclusions: Hospital availability of TCC was not associated with improved outcomes for in-hospital cardiac arrest.",
keywords = "Cardiopulmonary arrest, Cardiopulmonary resuscitation, Critical Care, Tele-Critical Care, Tele-ICU, Telehealth, Telemedicine",
author = "{American Heart Association's Get With The Guidelines{\textregistered}-Resuscitation Investigators} and Ofoma, {Uchenna R.} and Drewry, {Anne M.} and Maddox, {Thomas M.} and Walter Boyle and Elena Deych and Marin Kollef and Saket Girotra and {Joynt Maddox}, {Karen E.}",
note = "Funding Information: Dr. Ofoma is supported by the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) award # KL2 TR002346. Funding Information: Dr. Karen Joynt Maddox is supported by the National Heart, Lung, and Blood Institute (R01HL143421) and National Institute on Aging (R01AG060935, R01AG063759, and R21AG065526). Funding Information: The manuscript was edited by the Scientific Editing Service of the Institute of Clinical and Translational Sciences at Washington University, which is supported by an NIH Clinical and Translational Science Award (UL1 TR002345). Funding Information: Financial Support : This project was supported by (i) the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH), under award # KL2 TR002346; (ii) the Center for Administrative Data research, which is supported in part by the Washington University Institute of Clinical and Translational Sciences CTSA grant #UL1 TR002345 from the NCATS of the NIH, and grant #R24 HS19455 awarded by the Agency for Healthcare Research and Quality (AHRQ). Funding Information: Dr. Marin Kollef is supported by the Barnes-Jewish Hospital Foundation Funding Information: The GWTG programs are provided by the American Heart Association. Hospitals participating in the registry submit clinical information regarding the medical history, hospital care, and outcomes of consecutive patients hospitalized for cardiac arrest using an online, interactive case report form and Patient Management Tool{\texttrademark} (IQVIA, Parsippany, New Jersey). IQVIA serves as the data collection (through their Patient Management Tool) and coordination center for the American Heart Association/American Stroke Association GWTG programs. The University of Pennsylvania serves as the data analytic center and has an agreement to prepare the data for research purposes. We thank Scott Appel of the Biostatistics Analysis Center at the University of Pennsylvania for technical assistance with data set linkages. We thank RJ Waken, PhD, for technical assistance with data visualization productions. The manuscript was edited by the Scientific Editing Service of the Institute of Clinical and Translational Sciences at Washington University, which is supported by an NIH Clinical and Translational Science Award (UL1 TR002345). Financial Support: This project was supported by (i) the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH), under award # KL2 TR002346; (ii) the Center for Administrative Data research, which is supported in part by the Washington University Institute of Clinical and Translational Sciences CTSA grant #UL1 TR002345 from the NCATS of the NIH, and grant #R24 HS19455 awarded by the Agency for Healthcare Research and Quality (AHRQ). Dr. Ofoma is supported by the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) award # KL2 TR002346. Dr. Marin Kollef is supported by the Barnes-Jewish Hospital Foundation, Dr. Karen Joynt Maddox is supported by the National Heart, Lung, and Blood Institute (R01HL143421) and National Institute on Aging (R01AG060935, R01AG063759, and R21AG065526). Publisher Copyright: {\textcopyright} 2022 Elsevier B.V.",
year = "2022",
month = aug,
doi = "10.1016/j.resuscitation.2022.06.008",
language = "English (US)",
volume = "177",
pages = "7--15",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",
}