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Signa vitae : journal for intesive care and emergency medicine, Vol. 15 No. 1, 2019.

Original scientific paper

https://doi.org/10.22514/SV151.042019.7

Effect of transported hospital resources on neurologic outcome after out-of-hospital cardiac arrest

JOO YEONG KIM
SUNGWOO MOON ; Department of Emergency Medicine Korea University Ansan Hospital Ansan, Gyeonggi-do, South Korea
JONG HAK PARK
HAN JIN CHO
JU HYUN SONG
WOOCHAN JEON
HANSOEK CHANG
YOUNG SUN RO
SANG DO SHIN

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Abstract

Objective. Appropriate regional transport protocol for out-of-hospital cardiac arrest (OHCA) patients is important for achieving favorable outcomes in a certain community. This study aimed to investigate the effect of transported hospital resources on the neurologic outcome after OHCA.

Methods. We categorized cardiac receiving centers (CRC) in our community into two levels (primary [P-CRC] and definite CRC [D-CRC]) according to the hospital resources that were identified by the Hospital Assessment Survey in 2015. OHCA patients with presumed cardiac etiology resuscitated by emergency medical service providers between 2012 and 2014, were enrolled in the study. The main exposure was the level of CRC. The primary endpoint was discharge with good neurologic outcomes. We compared outcomes between CRCs after adjusting for potential confounders.

Results. Among the 9,912 patients, 5,876 were transported to P-CRC and 4,036 to D-CRC from 2012 to 2014. Patients admitted to D-CRC showed better neurologic outcome than those admitted to P-CRC (6.2% vs 1.5%, p<0.001). With regard to patients who survived to admission, the neurologic outcome of patients in D-CRC was better than those in P-CRC (11.3% vs 3.3%, p<0.001). In the multivariable logistic model, the adjusted odds ratio for all OHCA patients was 2.10 (95% confidence interval, 1.51–2.95).

Conclusion. Transportation of OHCA patients to the D-CRC resulted in significantly good neurologic outcome than those transported to P-CRC. Further research is needed to establish a regional OHCA transport protocol.

Keywords

cardiac arrest; outcome; regionalization

Hrčak ID:

219765

URI

https://hrcak.srce.hr/219765

Publication date:

1.5.2019.

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