Forskelle mellem hospitaler i prognose efter hjertestop uden for hospital

TY - JOUR

T1 - Forskelle mellem hospitaler i prognose efter hjertestop uden for hospital

AU - Kjaergaard, Jesper

AU - Bro-Jeppesen, John

AU - Rasmussen, Lars Simon

AU - Nielsen, Søren Loumann

AU - Folke, Fredrik

AU - Lippert, Freddy

AU - Wanscher, Michael C

AU - Hassager, Christian

N1 - Keywords: Adult; Aged; Ambulances; Cardiology Service, Hospital; Cardiopulmonary Resuscitation; Denmark; Emergency Medical Services; Female; Heart Arrest; Humans; Male; Middle Aged; Patient Admission; Prognosis; Registries; Risk Factors; Time Factors

PY - 2009

Y1 - 2009

N2 - INTRODUCTION: There are substantial differences in long-term survival of patients resuscitated from out-of-hospital cardiac arrest, and the level of care during hospitalization may be a contributing factor. The purpose of this study was to determine if a difference in long-term prognosis between hospitals could be detected in patients surviving cardiac arrest in Copenhagen. MATERIAL AND METHODS: The mobile emergency care unit attempted resuscitation in 1,098 patients with out-of-hospital cardiac arrest in the period 2002 to 2006, among whom return of spontaneous circulation occurred in 336 (30%) of the patients admitted to hospital. Survival was determined using the Central Population Registry through Statistics Denmark. RESULTS: Patients admitted to a tertiary facility were younger, more frequently male, they had more commonly ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) as their initial rhythm, and they had more frequently received bystander cardiopulmonary resuscitation. Survival at 4.6 years was 41% in patients admitted to the tertiary hospital and 10% in patients admitted to other hospitals, p < 0.0001. After adjustment for other known risk factors, patients admitted to other hospitals had a hazard ratio of 1.8 for death (95% confidence interval: 1,4-2,5) compared with patients admitted to a tertiary facility. CONCLUSION: The survival rate after out-of-hospital cardiac arrest was significantly higher in patients admitted to a tertiary facility than among patients admitted to less specialized hospitals. Further studies are needed to identify causal factors. Udgivelsesdato: 2009-Jun-22

AB - INTRODUCTION: There are substantial differences in long-term survival of patients resuscitated from out-of-hospital cardiac arrest, and the level of care during hospitalization may be a contributing factor. The purpose of this study was to determine if a difference in long-term prognosis between hospitals could be detected in patients surviving cardiac arrest in Copenhagen. MATERIAL AND METHODS: The mobile emergency care unit attempted resuscitation in 1,098 patients with out-of-hospital cardiac arrest in the period 2002 to 2006, among whom return of spontaneous circulation occurred in 336 (30%) of the patients admitted to hospital. Survival was determined using the Central Population Registry through Statistics Denmark. RESULTS: Patients admitted to a tertiary facility were younger, more frequently male, they had more commonly ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) as their initial rhythm, and they had more frequently received bystander cardiopulmonary resuscitation. Survival at 4.6 years was 41% in patients admitted to the tertiary hospital and 10% in patients admitted to other hospitals, p < 0.0001. After adjustment for other known risk factors, patients admitted to other hospitals had a hazard ratio of 1.8 for death (95% confidence interval: 1,4-2,5) compared with patients admitted to a tertiary facility. CONCLUSION: The survival rate after out-of-hospital cardiac arrest was significantly higher in patients admitted to a tertiary facility than among patients admitted to less specialized hospitals. Further studies are needed to identify causal factors. Udgivelsesdato: 2009-Jun-22

M3 - Tidsskriftartikel

C2 - 19671397

SN - 0041-5782

VL - 171

SP - 2169

EP - 2173

JO - Ugeskrift for Laeger

JF - Ugeskrift for Laeger

IS - 26

ER -