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Defibrillation Comes Late in 30 Percent of Hospital Cases
Date:1/3/2008

Heart treatment doesn't always begin in recommended 2 minutes, study shows

WEDNESDAY, Jan. 2 (HealthDay News) -- About a third of patients who suffer cardiac arrest in hospitals don't get a defibrillator-delivered shock to start the heart beating again within the two minutes recommended by the American Heart Association, a new study found.

This delay significantly reduces a patient's chance of survival, the study authors said.

"Until now, the recommendation for defibrillation within two minutes was based on expert opinion," said Dr. Paul S. Chan, who led the study while at the University of Michigan and now is a cardiologist with Saint Luke's Mid-America Heart Institute in Kansas City, Mo. "There were no clear standards established. This study helps support the two-minute recommendation."

The findings are published in the Jan. 3 issue of the New England Journal of Medicine.

Cardiac arrest is a too-common hospital problem. An estimated 750,000 patients experience cardiac arrest in U.S. hospitals each year, the study authors said.

Chan and his collaborators identified almost 6,800 people who had cardiac arrest at 369 hospitals participating in the National Registry of Cardiopulmonary Resuscitation. Overall, the response time seemed impressive, with defibrillation typically beginning an average of one minute after the heart stopped.

But defibrillation did not begin for two or more minutes in 2,045 cases, 30.1 percent of the total. Just 22.2 percent of that subgroup of patients survived to leave the hospital, compared to 39.3 percent of those who got early defibrillation, the study found.

"If we had the ability to look at all the hospitals across the country, the numbers probably would be worse," said Chan, referring both to the time defibrillation begins and chance of survival. "These are the better-performing hospitals, ones that issue quarterly reports."

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