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    Survival to hospital discharge is equivalent to 30-day survival as a primary survival outcome for out-of-hospital cardiac arrest studies.

    Access Status
    Fulltext not available
    Embargo Lift Date
    2022-07-25
    Authors
    Majewski, David
    Ball, Stephen
    Bailey, Paul
    Mckenzie, Nicole
    Bray, Janet
    Morgan, Alani
    Finn, Judith
    Date
    2021
    Type
    Journal Article
    
    Metadata
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    Citation
    Majewski, D. and Ball, S. and Bailey, P. and Mckenzie, N. and Bray, J. and Morgan, A. and Finn, J. 2021. Survival to hospital discharge is equivalent to 30-day survival as a primary survival outcome for out-of-hospital cardiac arrest studies. Resuscitation.
    Source Title
    Resuscitation
    DOI
    10.1016/j.resuscitation.2021.07.023
    ISSN
    0300-9572
    Faculty
    Faculty of Health Sciences
    School
    Curtin School of Nursing
    Funding and Sponsorship
    http://purl.org/au-research/grants/nhmrc/1116453
    http://purl.org/au-research/grants/nhmrc/1029983
    http://purl.org/au-research/grants/nhmrc/1174838
    URI
    http://hdl.handle.net/20.500.11937/85265
    Collection
    • Curtin Research Publications
    Abstract

    AIM: The 2015 Utstein guidelines stated that 30-day survival could be used as an alternative to survival to hospital discharge (STHD) as the primary survival outcome in out-of-hospital cardiac arrest (OHCA) studies. We sought to ascertain the equivalence (concordance) of these two survival outcome measures.

    METHODS: We conducted a population-based retrospective cohort study of OHCA patients who were attended by St John Western Australia (SJ-WA) paramedics in Perth, WA between 1999 and 2018. OHCA patients were included if they received either an attempted resuscitation by SJ-WA or bystander defibrillation; were a resident of WA; and were transported to a hospital emergency department (ED). STHD was determined through hospital record review and 30-day survival via the WA Death Registry and cemetery registration data.

    RESULTS: The study cohort comprised a total of 7,953 OHCA patients, predominantly male (70%), with a median (IQR) age of 63 (46-77 years), a presumed cardiac arrest aetiology (78.9%), and the majority occurred in a private residence (66.8%). Survival rates were identical for STHD and 30-day survival, with both being (13.78%, 95% CI: 13.02-14.54%) (p > 0.99). The overall concordance between the two survival rates was 99.6%. There were only 30 (0.4%) discordant cases in total: 15 cases with STHD-yes but 30-day survival-no; and 15 cases with STHD-no but 30-day survival-yes.

    CONCLUSION: We found that STHD and 30-day survival were equivalent survival metrics in our OHCA Registry. However, given potential differences in health systems, we suggest that 30-day survival is likely to enable more reliable comparisons across jurisdictions.

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