TY - JOUR
T1 - Predicting Survival After Out-of-Hospital Cardiac Arrest
T2 - Role of the Utstein Data Elements
AU - Rea, Thomas D.
AU - Cook, Andrea J.
AU - Stiell, Ian G.
AU - Powell, Judy
AU - Bigham, Blair
AU - Callaway, Clifton W.
AU - Chugh, Sumeet
AU - Aufderheide, Tom P.
AU - Morrison, Laurie
AU - Terndrup, Thomas E.
AU - Beaudoin, Tammy
AU - Wittwer, Lynn
AU - Davis, Dan
AU - Idris, Ahamed
AU - Nichol, Graham
N1 - Funding Information:
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This study was supported by a series of cooperative agreements to 10 regional centers and 1 data coordinating center ( 5U01 HL077863 , HL077881 , HL077871 , HL077872 , HL077866 , HL077908 , HL077867 , HL077885 , HL077887 , HL077873 , HL077865 ) with the National Heart, Lung, and Blood Institute , in partnership with the National Institute of Neurological Disorders and Stroke , US Army Research and Materiel Command , The Canadian Institutes of Health Research-Institute of Circulatory and Respiratory Health , Defense Research and Development Canada , American Heart Association , and the Heart and Stroke Foundation of Canada .
PY - 2010/3
Y1 - 2010/3
N2 - Study objective: Survival after out-of-hospital cardiac arrest depends on the links in the chain of survival. The Utstein elements are designed to assess these links and provide the basis for comparing outcomes within and across communities. We assess whether these measures sufficiently predict survival and explain outcome differences. Methods: We used an observational, prospective data collection, case-series of adult persons with nontraumatic out-of-hospital cardiac arrest from December 1, 2005, through March 1, 2007, from the multisite, population-based Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. We used logistic regression, receiver operating curves, and measures of variance to estimate the extent to which the Utstein elements predicted survival to hospital discharge and explained outcome variability overall and between 7 Resuscitation Outcomes Consortium sites. Analyses were conducted for all emergency medical services-treated cardiac arrests and for the subset of bystander-witnessed patient arrests because of presumed cardiac cause presenting with ventricular fibrillation or ventricular tachycardia. Results: Survival was 7.8% overall (n=833/10,681) and varied from 4.6% to 14.7% across Resuscitation Outcomes Consortium sites. Among bystander-witnessed ventricular fibrillation or ventricular tachycardia, survival was 22.1% overall (n=323/1459) and varied from 12.5% to 41.0% across sites. The Utstein elements collectively predicted 72% of survival variability among all arrests and 40% of survival variability among bystander-witnessed ventricular fibrillation. The Utstein elements accounted for 43.6% of the between-site survival difference among all arrests and 22.3% of the between-site difference among the bystander-witnessed ventricular fibrillation subset. Conclusion: The Utstein elements predict survival but account for only a modest portion of outcome variability overall and between Resuscitation Outcomes Consortium sites. The results underscore the need for ongoing investigation to better understand characteristics that influence cardiac arrest survival.
AB - Study objective: Survival after out-of-hospital cardiac arrest depends on the links in the chain of survival. The Utstein elements are designed to assess these links and provide the basis for comparing outcomes within and across communities. We assess whether these measures sufficiently predict survival and explain outcome differences. Methods: We used an observational, prospective data collection, case-series of adult persons with nontraumatic out-of-hospital cardiac arrest from December 1, 2005, through March 1, 2007, from the multisite, population-based Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. We used logistic regression, receiver operating curves, and measures of variance to estimate the extent to which the Utstein elements predicted survival to hospital discharge and explained outcome variability overall and between 7 Resuscitation Outcomes Consortium sites. Analyses were conducted for all emergency medical services-treated cardiac arrests and for the subset of bystander-witnessed patient arrests because of presumed cardiac cause presenting with ventricular fibrillation or ventricular tachycardia. Results: Survival was 7.8% overall (n=833/10,681) and varied from 4.6% to 14.7% across Resuscitation Outcomes Consortium sites. Among bystander-witnessed ventricular fibrillation or ventricular tachycardia, survival was 22.1% overall (n=323/1459) and varied from 12.5% to 41.0% across sites. The Utstein elements collectively predicted 72% of survival variability among all arrests and 40% of survival variability among bystander-witnessed ventricular fibrillation. The Utstein elements accounted for 43.6% of the between-site survival difference among all arrests and 22.3% of the between-site difference among the bystander-witnessed ventricular fibrillation subset. Conclusion: The Utstein elements predict survival but account for only a modest portion of outcome variability overall and between Resuscitation Outcomes Consortium sites. The results underscore the need for ongoing investigation to better understand characteristics that influence cardiac arrest survival.
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U2 - 10.1016/j.annemergmed.2009.09.018
DO - 10.1016/j.annemergmed.2009.09.018
M3 - Article
C2 - 19944488
AN - SCOPUS:76649084536
SN - 0196-0644
VL - 55
SP - 249
EP - 257
JO - Annals of emergency medicine
JF - Annals of emergency medicine
IS - 3
ER -