"This study shows that when you follow quality and you benchmark people you can improve performance," said Dr. Ralph Sacco, a past president of the American Heart Association and chairman of neurology at the University of Miami Miller School of Medicine, in Florida.
Data for the research was taken from a national quality-improvement registry that includes all hospitalized patients with a confirmed cardiac arrest who have received CPR in participating hospitals.
For this study, records for more than 84,600 patients aged 18 or older from 374 hospitals were included, adjusting for myriad factors, Girotra said, including age, sex, race and the presence of other conditions. Patients were excluded if their cardiac arrests occurred in operating rooms, procedural suites, labor and delivery, or emergency departments.
The study authors estimate that given the improved rate of survival they found, an additional 17,200 patients survived to hospital discharge in 2009 as compared with 2000. The rate of surviving the resuscitation attempt but not surviving the hospital stay was about 54 percent, up from nearly 43 percent in 2000.
Another research team examined information on Medicare patients who had CPR after in-hospital cardiac arrest from 1992 through 2005 and found no difference in survival rates to discharge. Girotra said those results, published in the New England Journal of Medicine in 2009, were likely affected by the fact that the researchers used data from administrative claims that may have included patients who hadn't had cardiac arrests or excluded those without the proper billing procedure code.
Sacco hopes researchers will now evaluate how to improve the outcomes of cardiac arrests that occur in public places. "Improving resuscitation after cardiac arrest is one of the big goals of the AH
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