A national analysis of the relationship between hospital factors and post-cardiac arrest mortality

Byline: Brendan G. Carr (1,2,4,5), Munish Goyal (2,3), Roger A. Band (2), David F. Gaieski (2,3), Benjamin S. Abella (2,3), Raina M. Merchant (1,2,3,4), Charles C. Branas (5), Lance B. Becker (2,3), Robert W. Neumar (2,3) Abstract: Purpose We sought to generate national estimates for post-cardiac arrest mortality, to assess trends, and to identify hospital factors associated with survival. Methods We used a national sample of US hospitals to identify patients resuscitated after cardiac arrest from 2000 to 2004 to describe the association between hospital factors (teaching status, location, size) and mortality, length of stay, and hospital charges. Analyses were performed using logistic regression. Results A total of 109,739 patients were identified. In-hospital mortality was 70.6%. A 2% decrease in unadjusted mortality from 71.6% in 2000 to 69.6% in 2004 (OR 0.96, P < 0.001) was observed. Mortality was lower at teaching hospitals (OR 0.58, P = 0.001), urban hospitals (OR 0.63, P = 0.004), and large hospitals (OR 0.55, P < 0.001). Conclusion Mortality after in-hospital cardiac arrest decreased over 5 years. Mortality was lower at urban, teaching, and large hospitals. There are implications for dissemination of best practices or regionalization of post-cardiac arrest care. Author Affiliation: (1) The Robert Wood Johnson Clinical Scholars Program, University of Pennsylvania School of Medicine, 932 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA (2) Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, USA (3) Center for Resuscitation Science, University of Pennsylvania School of Medicine, Philadelphia, USA (4) The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA (5) Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, USA Article History: Registration Date: 08/10/2008 Received Date: 28/04/2008 Accepted Date: 26/09/2008 Online Date: 21/10/2008