Biomaterial Database

Improving Temporal Trends in Survival and Neurological Outcomes After Out-of-Hospital Cardiac Arrest. 2018

Jason E Buick, and Ian R Drennan, and Damon C Scales, and Steven C Brooks, and Adams Byers, and Sheldon Cheskes, and Katie N Dainty, and Michael Feldman, and P Richard Verbeek, and Cathy Zhan, and Alex Kiss, and Laurie J Morrison, and Steve Lin, and

From Rescu, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada (J.E.B., I.R.D., S.C.B., A.B., S.C., K.N.D., C.Z., L.J.M., S.L.); Division of Emergency Medicine, Department of Medicine (J.E.B., I.R.D., S.C.B., A.B., S.C., K.N.D., C.Z., L.J.M., S.L.), Institute of Medical Science (I.R.D.), Institute of Health Policy, Management and Evaluation (D.C.S., J.E.B., K.N.D., A.K., L.J.M., S.L.), Interdepartmental Division of Critical Care, Department of Medicine (D.C.S.), Division of Emergency Medicine, Department of Family and Community Medicine (S.C.), University of Toronto, ON, Canada; Department of Critical Care Medicine (D.C.S.) and Sunnybrook Center for Prehospital Medicine (S.C., M.F., P.R.V.), Sunnybrook Health Sciences Center, Toronto, ON, Canada; and Department of Emergency Medicine, Faculty of Health Sciences, Queens University, Kingston, ON, Canada (S.C.B.). buickj@smh.ca morrisonl@smh.ca.

Considerable effort has gone into improving outcomes from out-of-hospital cardiac arrest (OHCA). Studies suggest that survival is improving; however, prior studies had insufficient data to pursue the relationship between markers of guideline compliance and temporal trends. The objective of the study was to evaluate trends in OHCA survival over an 8-year period that included the implementation of the 2005 and 2010 international cardiopulmonary resuscitation (CPR) guidelines. This was a population-based cohort study of all consecutive treated OHCA patients of presumed cardiac cause between 2006 and 2013 in the City of Toronto, Canada, and surrounding regions. Temporal changes were measured by χ2 trend test. The association between year of the OHCA and survival was evaluated using logistic regression and joinpoint analysis. A total of 23 619 patients with OHCA met study inclusion criteria. During the study period, survival to hospital discharge doubled (4.8% in 2006 to 9.4% in 2013; P<0.0001), and survival with good neurological outcome increased (6.2% in 2010 to 8.5% in 2013; P=0.005). Improvements occurred in the rates of bystander CPR and automated external defibrillator application, high-quality CPR metrics, and in-hospital targeted temperature management. After adjusting for the Utstein variables, survival to hospital discharge (odds ratio, 1.12; 95% confidence interval, 1.09-1.15) and survival with good neurological outcome (odds ratio, 1.13; 95% confidence interval, 1.05-1.22) increased with each year of study. Survival after OHCA has improved over time. This trend was associated with improved rates of bystander CPR, automated external defibrillator use, high-quality CPR metrics, and in-hospital targeted temperature management. The results suggest that multiple factors, each improving over time, may have contributed to the observed increase in survival.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009864	Ontario	A province of Canada lying between the provinces of Manitoba and Quebec. Its capital is Toronto. It takes its name from Lake Ontario which is said to represent the Iroquois oniatariio, beautiful lake. (From Webster's New Geographical Dictionary, 1988, p892 & Room, Brewer's Dictionary of Names, 1992, p391)
D010818	Practice Patterns, Physicians'	Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.	Clinical Practice Patterns,Physician's Practice Patterns,Clinical Practice Pattern,Pattern, Clinical Practice,Patterns, Clinical Practice,Practice Pattern, Clinical,Practice Patterns, Clinical,Practice Patterns, Physician's,Prescribing Patterns, Physician,Physician Practice Patterns,Physician Prescribing Pattern,Physician Prescribing Patterns,Physician's Practice Pattern,Physicians' Practice Pattern,Physicians' Practice Patterns,Practice Pattern, Physician's,Practice Pattern, Physicians',Practice Patterns, Physician,Prescribing Pattern, Physician
D004554	Electric Countershock	An electrical current applied to the HEART to terminate a CARDIAC ARRHYTHMIA.	Cardiac Electroversion,Cardioversion,Defibrillation, Electric,Electroversion, Cardiac,Electrical Cardioversion,Electroversion Therapy,Therapy, Electroversion,Cardiac Electroversions,Cardioversion, Electrical,Cardioversions,Cardioversions, Electrical,Countershock, Electric,Countershocks, Electric,Defibrillations, Electric,Electric Countershocks,Electric Defibrillation,Electric Defibrillations,Electrical Cardioversions,Electroversion Therapies,Electroversions, Cardiac,Therapies, Electroversion
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D000369	Aged, 80 and over	Persons 80 years of age and older.	Oldest Old
D012189	Retrospective Studies	Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.	Retrospective Study,Studies, Retrospective,Study, Retrospective