Out-of-hospital cardiac arrest outcomes in emergency departments
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: Da...
| Main Authors: | , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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ELSEVIER IRELAND LTD
2021
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1174838 http://hdl.handle.net/20.500.11937/93321 |
| _version_ | 1848765719911596032 |
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| author | Kempster, K. Howell, S. Bernard, S. Smith, K. Cameron, P. Finn, Judith Stub, D. Morley, P. Bray, Janet |
| author_facet | Kempster, K. Howell, S. Bernard, S. Smith, K. Cameron, P. Finn, Judith Stub, D. Morley, P. Bray, Janet |
| author_sort | Kempster, K. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T11:39:44Z |
| format | Journal Article |
| id | curtin-20.500.11937-93321 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:39:44Z |
| publishDate | 2021 |
| publisher | ELSEVIER IRELAND LTD |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-933212023-10-11T00:56:07Z Out-of-hospital cardiac arrest outcomes in emergency departments Kempster, K. Howell, S. Bernard, S. Smith, K. Cameron, P. Finn, Judith Stub, D. Morley, P. Bray, Janet Science & Technology Life Sciences & Biomedicine Critical Care Medicine Emergency Medicine General & Internal Medicine Out-of-hospital cardiac arrest Heart arrest Emergency department Registries INTERNATIONAL LIAISON COMMITTEE AMERICAN-HEART-ASSOCIATION HEALTH-CARE PROFESSIONALS POSTRESUSCITATION CARE EUROPEAN RESUSCITATION REGIONAL-VARIATION STROKE FOUNDATION MEDICAL-SERVICES TASK-FORCE SURVIVAL Emergency department Heart arrest Out-of-hospital cardiac arrest Registries Adult Ambulances Cardiopulmonary Resuscitation Emergency Medical Services Emergency Service, Hospital Humans Out-of-Hospital Cardiac Arrest Registries Retrospective Studies Humans Cardiopulmonary Resuscitation Registries Retrospective Studies Ambulances Adult Emergency Service, Hospital Emergency Medical Services Out-of-Hospital Cardiac Arrest 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. 2021 Journal Article http://hdl.handle.net/20.500.11937/93321 10.1016/j.resuscitation.2021.07.003 English http://purl.org/au-research/grants/nhmrc/1174838 http://purl.org/au-research/grants/nhmrc/1116453 ELSEVIER IRELAND LTD fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Critical Care Medicine Emergency Medicine General & Internal Medicine Out-of-hospital cardiac arrest Heart arrest Emergency department Registries INTERNATIONAL LIAISON COMMITTEE AMERICAN-HEART-ASSOCIATION HEALTH-CARE PROFESSIONALS POSTRESUSCITATION CARE EUROPEAN RESUSCITATION REGIONAL-VARIATION STROKE FOUNDATION MEDICAL-SERVICES TASK-FORCE SURVIVAL Emergency department Heart arrest Out-of-hospital cardiac arrest Registries Adult Ambulances Cardiopulmonary Resuscitation Emergency Medical Services Emergency Service, Hospital Humans Out-of-Hospital Cardiac Arrest Registries Retrospective Studies Humans Cardiopulmonary Resuscitation Registries Retrospective Studies Ambulances Adult Emergency Service, Hospital Emergency Medical Services Out-of-Hospital Cardiac Arrest Kempster, K. Howell, S. Bernard, S. Smith, K. Cameron, P. Finn, Judith Stub, D. Morley, P. Bray, Janet Out-of-hospital cardiac arrest outcomes in emergency departments |
| title | Out-of-hospital cardiac arrest outcomes in emergency departments |
| title_full | Out-of-hospital cardiac arrest outcomes in emergency departments |
| title_fullStr | Out-of-hospital cardiac arrest outcomes in emergency departments |
| title_full_unstemmed | Out-of-hospital cardiac arrest outcomes in emergency departments |
| title_short | Out-of-hospital cardiac arrest outcomes in emergency departments |
| title_sort | out-of-hospital cardiac arrest outcomes in emergency departments |
| topic | Science & Technology Life Sciences & Biomedicine Critical Care Medicine Emergency Medicine General & Internal Medicine Out-of-hospital cardiac arrest Heart arrest Emergency department Registries INTERNATIONAL LIAISON COMMITTEE AMERICAN-HEART-ASSOCIATION HEALTH-CARE PROFESSIONALS POSTRESUSCITATION CARE EUROPEAN RESUSCITATION REGIONAL-VARIATION STROKE FOUNDATION MEDICAL-SERVICES TASK-FORCE SURVIVAL Emergency department Heart arrest Out-of-hospital cardiac arrest Registries Adult Ambulances Cardiopulmonary Resuscitation Emergency Medical Services Emergency Service, Hospital Humans Out-of-Hospital Cardiac Arrest Registries Retrospective Studies Humans Cardiopulmonary Resuscitation Registries Retrospective Studies Ambulances Adult Emergency Service, Hospital Emergency Medical Services Out-of-Hospital Cardiac Arrest |
| url | http://purl.org/au-research/grants/nhmrc/1174838 http://purl.org/au-research/grants/nhmrc/1174838 http://hdl.handle.net/20.500.11937/93321 |