Survival Improving After In-Hospital Cardiac Arrest

Over the past decade, trend towards improved survival and neurologic outcomes

WEDNESDAY, Nov. 14 (HealthDay News) -- Over the past decade, there has been a trend toward improved survival and a decrease in neurologic disability following in-hospital cardiac arrest, according to a study published in the Nov. 15 issue of the New England Journal of Medicine.

Saket Girotra, M.D., from the University of Iowa Hospitals and Clinics in Iowa City, and colleagues examined temporal trends in survival and neurologic function for 84,625 adults who had an in-hospital cardiac arrest at 374 hospitals in the Get with the Guidelines-Resuscitation registry between 2000 and 2009.

Of the cohort, 79.3 percent had an initial rhythm of asystole or pulseless electrical activity, and the remaining 20.7 percent had ventricular fibrillation or pulseless ventricular tachycardia. The researchers observed a significant increase in the proportion of cardiac arrests due to asystole or pulseless electrical activity over time. There was a significant increase in risk-adjusted rates of survival to discharge, from 13.7 percent in 2000 to 22.3 percent in 2009 (adjusted rate ratio per year, 1.04; P < 0.001 for trend). In the two rhythm groups, improvements in survival were similar and were attributed to improvements in acute resuscitation survival and post-resuscitation survival. There was a significant decrease in the rates of clinically significant neurologic disability among survivors over time, with a risk-adjusted rate of 32.9 percent in 2000 and 28.1 percent in 2009 (adjusted rate ratio per year, 0.98; P = 0.02 for trend).

"Both survival and neurologic outcomes after in-hospital cardiac arrest have improved during the past decade at hospitals participating in a large national quality-improvement registry," the authors write.

Several authors disclosed financial ties to Prescription Solutions, UnitedHealthcare, and/or Medtronic.

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