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:10/13/2017)... ... 2017 , ... The Visiting Nurse Association (VNA) of Somerset Hills is proud ... and unique items from across the nation, this holiday-themed event will raise funds and ... the VNA. The boutique will be open Saturday, November 4 (10:00 a.m. – ...
(Date:10/13/2017)... Fairfax, VA (PRWEB) , ... October 13, 2017 ... ... provider of DevOps and Agile Software Development, has been awarded a contract by ... (EATS) Blanket Purchase Agreement (BPA) aims to accelerate the enterprise use of Agile ...
(Date:10/12/2017)... ... October 12, 2017 , ... Planet Fitness, one of the largest and ... plans to open a flagship location in Covington, LA at 401 N. U.S. Highway ... store next to Office Depot in the Holiday Square shopping center. Its location allows ...
(Date:10/12/2017)... ... 2017 , ... Information about the technology: , Otomagnetics has ... prevention of a major side effect of chemotherapy in children. Cisplatin and carboplatin ... cisplatin, hearing loss is FDA listed on-label as a dose limiting toxicity. Hearing ...
(Date:10/12/2017)... ... October 12, 2017 , ... Women-owned and Grand Rapids-based workplace ... Brightest in Wellness® by Best and Brightest. OnSite Wellness will be honored at ... from 7:30 a.m. to 2 p.m. at the Henry Autograph Collection Hotel, located ...
Breaking Medicine News(10 mins):
(Date:10/11/2017)... 11, 2017  True Health, a leader in ... effort during National Breast Cancer Awareness month to ... Research recently ... that more than 10 million American women are ... BRCA1 or BRCA2 and have not had testing. These ...
(Date:10/5/2017)... 5, 2017  In response to the nationwide ... Maxillofacial Surgeons (AAOMS) released prescribing recommendations that urge ... used as a first-line therapy to manage a ... Recognizing the value and importance ... "Opioid Prescribing: Acute and Postoperative Pain Management" stresses ...
(Date:10/2/2017)... -- Eli Lilly and Company (NYSE: LLY ) ... of 2017 on Tuesday, October 24, 2017. Lilly will ... the investment community and media to further detail the ... begin at 9 a.m. Eastern time. Investors, media and ... the conference call through a link that will be ...
Breaking Medicine Technology: