Acute cardiac care & resuscitationCohort study
Between-hospital variability in outcomes after cardiac arrest in a large clinical trial network
- prospective, multicenter study
- analysis of screening logs of a multicenter trial
- Bayesian hierarchical regressions
Authors' conclusion
This prospective, multicenter study suggests that the marked between-hospital variability in OHCA outcomes consistently observed in previous cohorts persists today. Improving outcomes at lower performance hospitals could have a substantial impact on survival and functional recovery after resuscitation from cardiac arrest.
Study context
- Population
- Patients screened for the ICECAP trial after resuscitation from OHCA, regardless of enrollment, at 69 hospitals between April 2020 and March 2024, excluding those who died prior to admission, those aged <18 years, those awake on presentation, and those with severe preexisting functional impairment or terminal illnesspatients included, across 69 hospitals
- Participants
- 8,603 patients
- Exposure
- Between-hospital variability in survival to discharge, overall and after adjustment for patient factors
Main finding
As reported in the abstract
Survived to discharge, of the 8603 patients included
2192 (25%)
Observational data: associations, not effects.
Further findings
Survival to discharge by site and between-site variability
- Median survival to discharge by site
- 28% [IQR 24-32%]
- Median odds ratio (median odds ratio (MOR)) across sites
- 1.80 (95% credible interval [CI] 1.72-1.91)
Between-site variability after adjusting for measured patient characteristics
- MOR, adjusted
- 1.90 [95% CI 1.80-2.03]
- between-site variability increased slightly
Site volume, temperature management practices and risk-adjusted outcomes (secondary analyses)
- No relationship between site volume or temperature management practices and risk-adjusted outcomes
Original publication
Summarised from the published abstract; every number is checked against it