Survival to hospital discharge is equivalent to 30-day survival as a primary survival outcome for out-of-hospital cardiac arrest studies.
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 m...
| Main Authors: | , , , , , , |
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| Format: | Journal Article |
| Language: | English |
| Published: |
2021
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1116453 http://hdl.handle.net/20.500.11937/85265 |
| _version_ | 1848764728118083584 |
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| author | Majewski, David Ball, Stephen Bailey, Paul Mckenzie, Nicole Bray, Janet Morgan, Alani Finn, Judith |
| author_facet | Majewski, David Ball, Stephen Bailey, Paul Mckenzie, Nicole Bray, Janet Morgan, Alani Finn, Judith |
| author_sort | Majewski, David |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T11:23:58Z |
| format | Journal Article |
| id | curtin-20.500.11937-85265 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | eng |
| last_indexed | 2025-11-14T11:23:58Z |
| publishDate | 2021 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-852652022-08-12T05:22:58Z Survival to hospital discharge is equivalent to 30-day survival as a primary survival outcome for out-of-hospital cardiac arrest studies. Majewski, David Ball, Stephen Bailey, Paul Mckenzie, Nicole Bray, Janet Morgan, Alani Finn, Judith 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. 2021 Journal Article http://hdl.handle.net/20.500.11937/85265 10.1016/j.resuscitation.2021.07.023 eng http://purl.org/au-research/grants/nhmrc/1116453 http://purl.org/au-research/grants/nhmrc/1029983 http://purl.org/au-research/grants/nhmrc/1174838 http://creativecommons.org/licenses/by-nc-nd/4.0/ fulltext |
| spellingShingle | Majewski, David Ball, Stephen Bailey, Paul Mckenzie, Nicole Bray, Janet Morgan, Alani Finn, Judith Survival to hospital discharge is equivalent to 30-day survival as a primary survival outcome for out-of-hospital cardiac arrest studies. |
| title | Survival to hospital discharge is equivalent to 30-day survival as a primary survival outcome for out-of-hospital cardiac arrest studies. |
| title_full | Survival to hospital discharge is equivalent to 30-day survival as a primary survival outcome for out-of-hospital cardiac arrest studies. |
| title_fullStr | Survival to hospital discharge is equivalent to 30-day survival as a primary survival outcome for out-of-hospital cardiac arrest studies. |
| title_full_unstemmed | Survival to hospital discharge is equivalent to 30-day survival as a primary survival outcome for out-of-hospital cardiac arrest studies. |
| title_short | Survival to hospital discharge is equivalent to 30-day survival as a primary survival outcome for out-of-hospital cardiac arrest studies. |
| title_sort | survival to hospital discharge is equivalent to 30-day survival as a primary survival outcome for out-of-hospital cardiac arrest studies. |
| url | http://purl.org/au-research/grants/nhmrc/1116453 http://purl.org/au-research/grants/nhmrc/1116453 http://purl.org/au-research/grants/nhmrc/1116453 http://hdl.handle.net/20.500.11937/85265 |