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Resuscitation. 2018 Feb;123:58-64. doi: 10.1016/j.resuscitation.2017.10.023. Epub 2017 Nov 2.

Long-Term Survival Trends of Medicare Patients After In-Hospital Cardiac Arrest: Insights from Get With The Guidelines-Resuscitation®.

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University of Colorado, Department of Cardiology, Aurora, CO, United States. Electronic address:
Mid-America Heart Institute, Kansas City, MO, United States.
University of Michigan, Ann Arbor, MI, United States.
University of Iowa, Iowa City, IA, United States.
University of Colorado, Department of Emergency Medicine, Aurora, CO, United States.
Harvard Medical School, Boston, MA, United States.
University of Colorado, Department of Cardiology, Aurora, CO, United States.
Minneapolis Heart Institute, Minneapolis, MN, United States.



Although rates of survival to hospital discharge after in-hospital cardiac arrest (IHCA) have improved over the last decade, it is unknown if these survival gains are sustained after hospital discharge.


To examine 1-year survival trends overall and by rhythm after IHCA.


Using Medicare beneficiaries (age≥65years) with IHCA occurring between 2000 and 2011 at Get With The Guidelines®-Resuscitation Registry participating hospitals we used multivariable regression, to examine temporal trends in risk-adjusted rates of 1-year survival.


Among 45,567 patients with IHCA, the unadjusted 1-year survival was 9.4%. Unadjusted 1-year survival was 21.8% among the 9,223 (20.2%) of patients with Ventricular Fibrillation or Pulseless Ventricular Tachycardia (VF/VT) and 6.2% among the 36,344 (79.8%) of patients with Pulseless Electrical Activity or asystole (PEA/asystole). After adjustment for patient and arrest characteristics, 1-year survival increased over time for all IHCA from 8.9% in 2000-2001 to 15.2% in 2011 (adjusted rate ratio [RR] per year, 1.05; 95% CI, 1.03-1.06; P<0.001 for trend). Improvements in 1-year risk adjusted survival were also observed for VF/VT (19.4% in 2000-2001 to 25.6% in 2011 [RR per year, 1.02; 95% CI, 1.01-1.04; P 0.004 for trend]) and PEA/asystole arrests (4.7% in 2000-2001 to 10.2% in 2011 [RR per year, 1.07; 95% CI, 1.05-1.08; P<0.001 for trend]).


Among Medicare beneficiaries in the GWTG-Resuscitation registry, 1-year survival after IHCA has increased for over the past decade. Temporal improvements in survival were noted for both shockable and non-shockable presenting arrest rhythms.


In-Hospital cardiac arrest; Outcomes; Resuscitation; Survival

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