Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Feb:123:58-64.
doi: 10.1016/j.resuscitation.2017.10.023. Epub 2017 Nov 2.

Long-Term Survival Trends of Medicare Patients After In-Hospital Cardiac Arrest: Insights from Get With The Guidelines-Resuscitation®

Lauren E Thompson  1 , Paul S Chan  2 , Fengming Tang  2 , Brahmajee K Nallamothu  3 , Saket Girotra  4 , Sarah M Perman  5 , Somnath Bose  6 , Stacie L Daugherty  7 , Steven M Bradley  8 ; American Heart Association’s Get With the Guidelines-Resuscitation Investigators
Affiliations

Long-Term Survival Trends of Medicare Patients After In-Hospital Cardiac Arrest: Insights from Get With The Guidelines-Resuscitation®

Lauren E Thompson et al. Resuscitation. 2018 Feb.

Abstract

Background: Although rates of survival to hospital discharge after in-hospital cardiac arrest (IHCA) have improved over the last decade, it is unknown if these survival gains are sustained after hospital discharge.

Objective: To examine 1-year survival trends overall and by rhythm after IHCA.

Methods: Using Medicare beneficiaries (age≥65years) with IHCA occurring between 2000 and 2011 at Get With The Guidelines®-Resuscitation Registry participating hospitals we used multivariable regression, to examine temporal trends in risk-adjusted rates of 1-year survival.

Results: Among 45,567 patients with IHCA, the unadjusted 1-year survival was 9.4%. Unadjusted 1-year survival was 21.8% among the 9,223 (20.2%) of patients with Ventricular Fibrillation or Pulseless Ventricular Tachycardia (VF/VT) and 6.2% among the 36,344 (79.8%) of patients with Pulseless Electrical Activity or asystole (PEA/asystole). After adjustment for patient and arrest characteristics, 1-year survival increased over time for all IHCA from 8.9% in 2000-2001 to 15.2% in 2011 (adjusted rate ratio [RR] per year, 1.05; 95% CI, 1.03-1.06; P<0.001 for trend). Improvements in 1-year risk adjusted survival were also observed for VF/VT (19.4% in 2000-2001 to 25.6% in 2011 [RR per year, 1.02; 95% CI, 1.01-1.04; P 0.004 for trend]) and PEA/asystole arrests (4.7% in 2000-2001 to 10.2% in 2011 [RR per year, 1.07; 95% CI, 1.05-1.08; P<0.001 for trend]).

Conclusion: Among Medicare beneficiaries in the GWTG-Resuscitation registry, 1-year survival after IHCA has increased for over the past decade. Temporal improvements in survival were noted for both shockable and non-shockable presenting arrest rhythms.

Keywords: In-Hospital cardiac arrest; Outcomes; Resuscitation; Survival.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

The authors have no relationships with industry to disclose. Dr. Thompson is supported by NIH/NCATS Colorado CTSI Grant Number UL1 TR001082. Dr. Chan is supported by funding from the NIH (1R01HL123980). Dr. Perman is supported by funding from the NIH (K12HD057022). Dr. Daugherty is supported by funding from the NIH (R01HL133343).

Figures

Fig. 1
Fig. 1
Study Design Flowsheet. Abbreviations: GWTG-R = Get With The Guidelines-Resuscitation® ; IHCA = in-hospital cardiac arrest.
Fig. 2
Fig. 2
Unadjusted Rates of Discharge, 30-day, and 1-Year Survival after In-Hospital Cardiac Arrest Overall and By Presenting Rhythm. Figure includes 45,567 patients with In-Hospital Cardiac Arrest at 525 Get With the Guideline-Resuscitation Hospital’s between 2000 and 2011. Figure demonstrates unadjusted discharge, 30-day, and 1-year survival rates. Abbreviations: Asystole/PEA = asystole or pulseless electrical activity; VT/VF = Pulseless Ventricular Tachycardia or Ventricular Fibrillation
See this image and copyright information in PMC

References

    1. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics–2013 update: a report from the American Heart Association. Circulation. 2013;127:e6–245. - PMC - PubMed
    1. Girotra S, Nallamothu BK, Spertus JA, Li Y, Krumholz HM, Chan PS. Trends in survival after In-Hospital cardiac arrest. N Engl J Med. 2012;367:1912–20. - PMC - PubMed
    1. Meaney PA, Nadkarni VM, Kern KB, Indik JH, Halperin HR, Berg RA. Rhythms and outcomes of adult in-hospital cardiac arrest. Crit Care Med. 2010;38:101–8. - PubMed
    1. Heffner AC, Pearson DA, Nussbaum ML, Jones AE. Regionalization of post-cardiac arrest care: implementation of a cardiac resuscitation center. Am Heart J. 2012;164:493–501. e2. - PubMed
    1. Peberdy MA, Kaye W, Ornato JP, et al. Cardiopulmonary resuscitation of adults in the hospital: a report of 14720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation. 2003;58:297–308. - PubMed

Publication types