Navigation Links
Penn study: Chances of surviving cardiac arrest depend on where patients are treated
Date:1/9/2009

(PHILADELPHIA) Efforts to fight the toll of cardiac arrest have typically focused on pre-hospital factors -- bystander CPR education and improvement, public defibrillation programs, and quicker EMS response. But new research from the University of Pennsylvania School of Medicine reveals that the hospital where patients are cared for after being resuscitated plays a key role in their chances of survival following these incidents, which takes the lives of more than 300,000 Americans each year.

Patients in large, urban, and teaching hospitals are more likely to survive compared to those in small, often rural, non-academic hospitals, according to a study published recently in the journal Intensive Care Medicine. A second study, published in Resuscitation, suggests that patients who are cared for in the highest volume intensive care units after cardiac arrest are also most apt to survive. The findings points to a need to explore the development of specialized, regional post-cardiac arrest care centers modeled after those that treat serious trauma patients, says lead author Brendan Carr, MD, an assistant professor of Emergency Medicine and Epidemiology, and associate director of the Division of Emergency Care Policy & Research.

Carr's findings also underscore the importance of the recent move by New York City to require ambulances to take cardiac arrest patients to hospitals that provide therapeutic hypothermia -- the so-called "cooling" therapy that protects against damage to the brain and other organs in the crucial hours after the heart is restored to its normal rhythm -- even if those facilities are further away.

"We are describing the variability that exists in cardiac arrest outcomes not at the level of the patient but at the level of the hospital. Hospitals with more resources and hospitals with higher volumes have better outcomes," Carr says. "There are two possible implications: Either we need to get everyone up to speed on how to optimize survival, or we need to selectively transfer patients to hospitals that have expertise in the post-arrest period."

The two studies, which examined a combined 115,000 cases in two different national datasets, also point to an overall improvement in cardiac arrest care. Over the course of the five years studied, the authors found a small reduction in mortality that translates to about 11,000 additional lives saved per year -- a significant decrease for a condition that is typically fatal. Better survival odds are multifactorial, but likely related to advances in critical care, the recognition of the role of hypothermia, and the creation of national guidelines for post-cardiac arrest care.

"There has been a fundamental shift such that we now recognize the condition patients experience after cardiac arrest as a treatable disease," says senior author Robert Neumar, MD, PhD, associate professor of Emergency Medicine and associate director of Penn's Center for Resuscitation Science, and Chair of the Advanced Cardiac Life Support Subcommittee for the American Heart Association. "Among the patients that regain a pulse after cardiac arrest, only one out of three survive to hospital discharge, and there appears to be significant variability among hospitals. Further research is needed to determine if this variability in outcome is caused by the quality of post-cardiac arrest care. If it is, we need to identify best practices and develop mechanisms to deliver optimal care for all patients."

Carr and his colleagues say further study of post-cardiac arrest care among these large, urban, and teaching hospitals will be crucial in mapping strategies that maximize a patient's chances to be discharged without the neurological deficits that often plague cardiac arrest survivors. And he emphasizes that practitioners can learn lessons from the connections between the way hospitals care for patients with cardiac arrest and other emergent conditions.

"For me, cardiac arrest is the tip of the iceberg with respect to disparities in care for time-sensitive conditions," Carr says. "Whether you've had a cardiac arrest, a stroke, or a heart attack, it is our job to build a system that promises you the best possible care no matter where you are, who you are, or what time of day it is."


'/>"/>

Contact: Holly Auer
holly.auer@uphs.upenn.edu
215-200-2313
University of Pennsylvania School of Medicine
Source:Eurekalert

Related medicine news :

1. Study: Fluoridation Benefits Doubtful
2. Study: How Can States Treat a Sick Economy? Call the Doctors
3. Study: Sandwich Generation Struggling With Dual Caregiver Responsibilities
4. New Easter Seals-MassMutual Study: Autism Strains Family Finances, Threatens Long-Term Care and Security
5. Study: Patient Harm More Common with Patient-Controlled Pain Medication
6. Study: Childhood constipation just as serious as asthma
7. Study: Want to be happier? Be more grateful
8. Study: Smoking Ban Would Help Reduce Heart Attack Admissions
9. New study: A Common Class of GI Medications Reduce Protection Against Heart Attack in Patients Taking Widely Prescribed Cardiovascular Drug
10. University of Illinois - Chicago Study: Raisins Contain Compounds that May Inhibit Cavity-causing Bacteria
11. Geisinger study: Increasing health care value improves health care quality
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/26/2017)... ... May 26, 2017 , ... Water damage to the flooring of several ... had left education officials with a number of critical issues to address before students ... to be accomplished with little or no disruption to class schedules. Second, the project ...
(Date:5/24/2017)... ... May 24, 2017 , ... In modern research, success depends ... instruments for research and understanding the basic principles that were designed to drive ... innovations in stereo microscopy for brightfield and fluorescence typically used in laboratories working ...
(Date:5/24/2017)... ... 24, 2017 , ... Altec Products, Inc., a leader in enterprise ... one-day technology conference in San Diego, CA. , At nVerge 2017, Altec will ... utilize and enhance their Sage ERP solutions by providing improved visibility and control to ...
(Date:5/24/2017)... ... May 24, 2017 , ... Drs. ... NY, who have now spent 10 years as clinical instructors for the reputable ... College of Dentistry. Through the program, private practitioners receive cutting-edge clinical training and ...
(Date:5/24/2017)... ... , ... Patients who want to receive cosmetic dentistry procedures such as Invisalign® ... for a consultation, with or without a referral. Dr. Bedich enjoys improving the appearance ... , Dr. Bedich offers a variety of cosmetic dentistry services at his practice that ...
Breaking Medicine News(10 mins):
(Date:5/10/2017)... MARLBOROUGH, Mass., May 10, 2017 Hologic, Inc. ... financial results for the fiscal second quarter ended April ... (EPS) of $1.84 increased 666.7% compared to the prior ... business resulted in a significant gain, while non-GAAP diluted ... increased 3.2%, or 3.8% in constant currency terms.  Excluding ...
(Date:5/10/2017)... Md. , May 10, 2017 CSSi, ... solutions for the clinical research industry, is proud to ... www.CSSiEnroll.com . The new website features both enriched content ... user experience and enhances the company,s already well-established position ... industry. "After many months of hard ...
(Date:5/9/2017)... 9, 2017  Semler Scientific, Inc. (OTCQB: SMLR), ... to improve the clinical effectiveness and efficiency of ... first quarter ended March 31, 2017. ... customers to identify when preventive care options are ... like heart attacks or strokes occur," said ...
Breaking Medicine Technology: