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Effect of annual hospital admissions of out-of-hospital cardiac arrest patients on prognosis following cardiac arrest
Title: | Effect of annual hospital admissions of out-of-hospital cardiac arrest patients on prognosis following cardiac arrest |
Authors: | Tsuchida, Takumi Browse this author | Ono, Kota Browse this author | Maekawa, Kunihiko Browse this author | Hayamizu, Mariko Browse this author | Hayakawa, Mineji Browse this author →KAKEN DB |
Keywords: | Cardiopulmonary resuscitation | Hospital volume | Neurological outcome | Out-of-hospital cardiac arrest | Prediction | Prognosis |
Issue Date: | 7-Jul-2022 |
Publisher: | BioMed Central |
Journal Title: | BMC Emergency Medicine |
Volume: | 22 |
Issue: | 1 |
Start Page: | 121 |
Publisher DOI: | 10.1186/s12873-022-00685-7 |
Abstract: | Background Although the prognosis of patients treated at specialized facilities has improved, the relationship between the number of patients treated at hospitals and prognosis is controversial and lacks constancy in those with out-of-hospital cardiac arrest (OHCA). This study aimed to clarify the effect of annual hospital admissions on the prognosis of adult patients with OHCA by analyzing a large cohort. Methods The effect of annual hospital admissions on patient prognosis was analyzed retrospectively using data from the Japanese Association for Acute Medicine OHCA registry, a nationwide multihospital prospective database. This study analyzed 3632 of 35,754 patients hospitalized for OHCA of cardiac origin at 86 hospitals. The hospitals were divided into tertiles based on the volume of annual admissions. The effect of hospital volume on prognosis was analyzed using logistic regression analysis with multiple imputation. Furthermore, three subgroup analyses were performed for patients with return of spontaneous circulation (ROSC) before arrival at the emergency department, patients admitted to critical care medical centers, and patients admitted to extracorporeal membrane oxygenation-capable hospitals. Results Favorable neurological outcomes 30 days after OHCA for patients overall showed no advantage for medium- and high-volume centers over low-volume centers; Odds ratio (OR) 0.989, (95% Confidence interval [CI] 0.562-1.741), OR 1.504 (95% CI 0.919-2.463), respectively. However, the frequency of favorable neurological outcomes in OHCA patients with ROSC before arrival at the emergency department at high-volume centers was higher than those at low-volume centers (OR 1.955, 95% CI 1.033-3.851). Conclusion Hospital volume did not significantly affect the prognosis of adult patients with OHCA. However, transport to a high-volume hospital may improve the neurological prognosis in OHCA patients with ROSC before arrival at the emergency department. |
Type: | article |
URI: | http://hdl.handle.net/2115/86800 |
Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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