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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®.

Author information

1
University of Colorado, Department of Cardiology, Aurora, CO, United States. Electronic address: Lauren.thompson@ucdenver.edu.
2
Mid-America Heart Institute, Kansas City, MO, United States.
3
University of Michigan, Ann Arbor, MI, United States.
4
University of Iowa, Iowa City, IA, United States.
5
University of Colorado, Department of Emergency Medicine, Aurora, CO, United States.
6
Harvard Medical School, Boston, MA, United States.
7
University of Colorado, Department of Cardiology, Aurora, CO, United States.
8
Minneapolis Heart Institute, Minneapolis, MN, United States.

Abstract

BACKGROUND:

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.

OBJECTIVE:

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

METHODS:

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.

RESULTS:

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]).

CONCLUSION:

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.

KEYWORDS:

In-Hospital cardiac arrest; Outcomes; Resuscitation; Survival

[Indexed for MEDLINE]
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