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Survival after cardiac arrest in hospital improves in the US

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e7830 (Published 21 November 2012) Cite this as: BMJ 2012;345:e7830

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Survival after cardiac arrest in hospital improved significantly between 2000 and 2009 in a study from the US. A large group of well motivated hospitals saw overall survival rise from 13.7% to 22.3% (P<0.001 for trend), while the prevalence of neurological disability in survivors fell from 32.9% to 28.1% (P=0.02). The authors report significant improvements in survival for adults with asystole or ventricular fibrillation, for men and women, and for adults under and over 65 years.

The positive trends remained significant through extensive adjustments for changes in patient and hospital characteristics, including a shift in initial rhythm (proportion with asystole or pulseless electrical activity 68.7% in 2000 and 82.4% in 2009).

By 2009, more people were surviving their initial arrest, and more of those survivors were making it home. The authors suspect that improvements in care before, during, and after an arrest are responsible and call for further work to find out. They analysed data from a register of cardiac arrests that did not record response times, quality of resuscitation techniques, or specific treatments such as hypothermia.

In all, 374 hospitals across the US contributed data to the register, which was set up as part of a quality improvement initiative. These findings may not extend to hospitals outside the network or to patients who arrest in emergency departments, procedure suites, and operating theatres, say the authors. All 84 625 adults in this study had their cardiac arrest on wards and intensive care units.

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Cite this as: BMJ 2012;345:e7830