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June 2017 - Andreas Schober

Dr. Andreas Schober

MedUni Vienna RESEARCHER OF THE MONTH, June 2017

Admission of out-of-hospital cardiac arrest victims to a high volume cardiac arrest center is linked to improved outcome

Aim: Cardiac arrest centers have been associated with improved outcome for patients after cardiac arrest. Aim of this prospective, multicenter, registry study was to investigate the effect on outcome depending on admission to high-, medium- or low volume centers.
Results: Out of 2238 patients (years 2013–2015) with emergency medical service resuscitation, 861 (32% female, age 64 (51;73) years) were admitted to 7 different centers. Favorable outcome was achieved in 267 patients (31%). In multivariate analysis, age below 65 years (OR 15; CI: 3.3–271.4; p=0.001), shockable initial heart rhythm (OR 10.1; CI: 2.4–42.6; p=0.002), immediate bystander or emergency medical service CPR (OR 11.2; CI: 1.4–93.3; p=0.025) and admission to a center with a frequency of >100 OHCA patients/year (OR 5.2; CI: 1.2–21.7; p=0.025) was associated with favorable outcome. Conclusions: High frequency of post-cardiac arrest treatment in a specialized center seems to be an independent predictor for favorable outcome in an unselected patient population after out of hospital cardiac arrest.

Selected literature

1  Schober A, Sterz F, Laggner AN, et al. Admission of out-of-hospital cardiac arrest victims to a high volume cardiac arrest center is linked to improved outcome. Resuscitation 2016;106:1–7. doi:10.1016/j.resuscitation.2016.06.021

2  Soar J, Nolan JP, Böttiger BW, et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation 2015;95:100–47. doi:10.1016/j.resuscitation.2015.07.016

3  Link MS, Berkow LC, Kudenchuk PJ, et al. Part 7: Adult Advanced Cardiovascular Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015;132:S444–64. doi:10.1161/CIR.0000000000000261

4  Soar J, Packham S. Cardiac arrest centres make sense. Resuscitation 2010;81:507–8. doi:10.1016/j.resuscitation.2010.01.017

5  Donnino MW, Rittenberger JC, Gaieski D, et al. The development and implementation of cardiac arrest centers. Resuscitation 2011;82:974–8. doi:10.1016/j.resuscitation.2011.03.021

Dr. Andreas Schober

Univ. Klinik f. Notfallmedizin
Medizinische Universität Wien
A-1090 Wien, Währinger Gürtel 18-20

Tel.: +43-1-40400-19640