Accredited Cardiac Arrest Centers Facilitate eCPR and Improve Neurological Outcome.
cardiac arrest center
extracorporeal cardio-pulmonary resuscitation
out-of-hospital cardiac arrest
outcomes
veno-arterial extracorporeal membrane oxygenation
Journal
Resuscitation
ISSN: 1873-1570
Titre abrégé: Resuscitation
Pays: Ireland
ID NLM: 0332173
Informations de publication
Date de publication:
05 Dec 2023
05 Dec 2023
Historique:
received:
01
08
2023
revised:
11
11
2023
accepted:
17
11
2023
medline:
8
12
2023
pubmed:
8
12
2023
entrez:
7
12
2023
Statut:
aheadofprint
Résumé
Out-of-hospital cardiac arrest (OHCA) remains a frequent medical emergency with low survival rates even after a return of spontaneous circulation (ROSC). Growing evidence supports formation of dedicated teams in scenarios like cardiogenic shock to improve prognosis. Thus, the European Resuscitation Council (ERC) recommended introduction of Cardiac Arrest Centers (CAC) in their 2015 guidelines. Here, we aimed to elucidate the effects of newly introduced CACs in Germany regarding survival rate and neurological outcome. A multicenter retrospective observational cohort study was performed at three university hospitals and outcomes after OHCA were compared before and after CAC accreditation. Primary outcomes were survival until discharge and favorable neurological status (CPC 1 or 2) at discharge. In total 784 patients (368 before and 416 after CAC accreditation) were analyzed. Rates of immediate percutaneous coronary intervention (40 vs. 52%, p= 0.01) and implementation of extracorporeal CPR (8 vs. 13%, p< 0.05) increased after CAC accreditation. Likelyhood of favorable neurological status at discharge was higher after CAC accreditation (71 vs. 87%, p< 0.01), whereas overall survival remained similar (35 vs. 35%, p> 0.99). CAC accreditation is linked to higher rates of favorable neurological outcome and unchanged overall survival.
Sections du résumé
BACKGROUND
BACKGROUND
Out-of-hospital cardiac arrest (OHCA) remains a frequent medical emergency with low survival rates even after a return of spontaneous circulation (ROSC). Growing evidence supports formation of dedicated teams in scenarios like cardiogenic shock to improve prognosis. Thus, the European Resuscitation Council (ERC) recommended introduction of Cardiac Arrest Centers (CAC) in their 2015 guidelines. Here, we aimed to elucidate the effects of newly introduced CACs in Germany regarding survival rate and neurological outcome.
METHODS
METHODS
A multicenter retrospective observational cohort study was performed at three university hospitals and outcomes after OHCA were compared before and after CAC accreditation. Primary outcomes were survival until discharge and favorable neurological status (CPC 1 or 2) at discharge.
RESULTS
RESULTS
In total 784 patients (368 before and 416 after CAC accreditation) were analyzed. Rates of immediate percutaneous coronary intervention (40 vs. 52%, p= 0.01) and implementation of extracorporeal CPR (8 vs. 13%, p< 0.05) increased after CAC accreditation. Likelyhood of favorable neurological status at discharge was higher after CAC accreditation (71 vs. 87%, p< 0.01), whereas overall survival remained similar (35 vs. 35%, p> 0.99).
CONCLUSION
CONCLUSIONS
CAC accreditation is linked to higher rates of favorable neurological outcome and unchanged overall survival.
Identifiants
pubmed: 38061578
pii: S0300-9572(23)00805-5
doi: 10.1016/j.resuscitation.2023.110069
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
110069Informations de copyright
Copyright © 2023. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.