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    Out-of-hospital cardiac arrest outcomes in emergency departments

    93145.pdf (381.1Kb)
    Access Status
    Open access
    Authors
    Kempster, K.
    Howell, S.
    Bernard, S.
    Smith, K.
    Cameron, P.
    Finn, Judith
    Stub, D.
    Morley, P.
    Bray, Janet
    Date
    2021
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Kempster, K. and Howell, S. and Bernard, S. and Smith, K. and Cameron, P. and Finn, J. and Stub, D. et al. 2021. Out-of-hospital cardiac arrest outcomes in emergency departments. Resuscitation. 166: pp. 21-30.
    Source Title
    Resuscitation
    DOI
    10.1016/j.resuscitation.2021.07.003
    ISSN
    0300-9572
    Faculty
    Faculty of Health Sciences
    School
    Curtin School of Nursing
    Funding and Sponsorship
    http://purl.org/au-research/grants/nhmrc/1174838
    http://purl.org/au-research/grants/nhmrc/1116453
    URI
    http://hdl.handle.net/20.500.11937/93321
    Collection
    • Curtin Research Publications
    Abstract

    Background: The emergency department (ED) plays an important role in out-hospital-cardiac arrest (OHCA) management. However, ED outcomes are not widely reported. This study aimed to (1) describe OHCA ED outcomes and reasons for ED deaths, and (2) whether these differed between hospitals. Methods: Data were obtained from the Victorian Ambulance Cardiac Arrest Registry and 12 hospitals for adult, non-traumatic OHCA cases transported to ED between 2014 and 2016. Multivariable logistic regression was used to examine the association of level of cardiac arrest centre on ED survival in a subset of cases (non-paramedic witnessed OHCA who were unconscious on ED arrival with ROSC). Results: Of 1547 eligible OHCA cases, 81% (N = 1254) survived ED, varying between 57% to 88% between EDs. Among non-survivors, the majority had either: cessation of resuscitation after presenting with CPR in progress (27%); withdrawal of life-sustaining treatment for non-neurological (n = 65, 22%) or neurological (16%) reasons; or a unsuccessful resuscitation following a rearrested in ED (20%). These causes of ED deaths varied between the different levels of cardiac arrest centres, and in our subset of interest (n = 952) ED survival was associated with transportation to centres with high annual OHCA volumes and with 24-hour cardiac intervention capabilities (AOR = 3.43, 95% CI 1.89–6.21). Conclusion: Our study found wide variation in survival between EDs, which was associated with hospital characteristics. Such data suggests the need for a detailed review of ED deaths, particularly in non-cardiac arrest centres, and potentially the need for monitoring ED survival as a measure of quality.

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