A Population-Based Retrospective Analysis of Post-In-Hospital Cardiac Arrest Survival after Modification of the Chain of Survival

Abstract

Background: In 2010, the American Heart Association recommended that postcardiac arrest care should be included in the chain of survival to reduce permanent neurological damage, improve quality of life, and reduce health care expenses of postcardiac arrest care. Objectives: To investigate post-in-hospital cardiac arrest (IHCA) survival prior to and after modification of the chain of survival in 2010, with subgroup analyses per age and concomitant coronary heart disease (CHD). Methods: We retrospectively searched the National Health Insurance Research Database for the 2007-2015 period to collect case data coded as ''427.41'' or ''427.5'' per International Classification of Disease Clinical Modification, Ninth revision codes and analyzed the data with SPSS v22.0. Results: The 1-day survival rate in the 2011-2015 period was 2% higher than that in the 2007-2010 period (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.01-1.04). Moreover, in the 2011-2015 period, the survival-to-discharge rate was increased by 1% in patients under 65 years (OR 1.01, 95% CI 1.00-1.02) and 1% in CHD patients (OR 1.01, 95% CI 1.01-1.02) compared with that in the 2007-2010 period. Conclusion: For patients with IHCA, the overall short-term survival improved significantly after modification of the chain of survival. Younger patients and patients with CHD had better long-term survival.

International facets of the ‘chain of survival’ for out-of-hospital and in-hospital cardiac arrest – A scoping review

“…The impact of the chain of survival on patient outcomes was reported either as an observation of increased survival rates and better neurologic outcome after the introduction of the 5th link of the chain by the AHA in 2010, 48 , 50 and increased bystander CPR rates after a public campaign about the chain of survival in France. 13 No educational or other outcomes were identified.…”

“…After data extraction, the reviewers met and reached a consensus on how to categorize the ideas within the articles included. We thus sorted the publication types into subgroups that were most suitable and internationally recognized (even though a specific journal may have classified a publication differently, e.g., “special report”), and thus report on four abstracts, 13 , 14 , 15 , 16 two commentaries, 17 , 18 five editorials, 19 , 20 , 21 , 22 , 23 ten letters, 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 five concepts, 34 , 35 , 36 , 37 , 38 three reviews, 39 , 40 , 41 four statements, 1 , 42 , 43 , 44 six reports of original research, 45 , 46 , 47 , 48 , 49 , 50 and four guidelines. 4 , 51 , 52 , 53 We further grouped the publications ( Supplementary Table S1 ) into “novel kinds of the concept related to resuscitation” ( n = 8), 1 , 4 , 18 , 30 , 31 , 32 , 49 , 51 “novel kinds of the concept not directly related to resuscitation” ( n = 23), 14 , 16 , 17 , 19 , 20 , …”

“… 4 , 51 , 52 , 53 We further grouped the publications ( Supplementary Table S1 ) into “novel kinds of the concept related to resuscitation” ( n = 8), 1 , 4 , 18 , 30 , 31 , 32 , 49 , 51 “novel kinds of the concept not directly related to resuscitation” ( n = 23), 14 , 16 , 17 , 19 , 20 , 21 , 22 , 23 , 28 , 29 , 33 , 34 , 35 , 37 , 38 , 40 , 41 , 43 , 45 , 46 , 47 , 52 , 53 “mere adaptations” ( n = 9), 15 , 24 , 25 , 26 , 27 , 36 , 39 , 42 , 44 and “impact on outcomes” ( n = 3). 13 , 48 , 50 We applied the World Bank definition to classify the countries of study origin into four categories by gross national income per capita to get an impression of the resource setting of the publications. The categories were: low-income economies, lower-middle-income economies, upper-middle-income economies and high-income economies.…”

Factors Associated With In-Hospital Post–Cardiac Arrest Survival in a Referral Level Hospital in Uganda

“…33 On the contrary, hemodynamic optimization through the prevention of hypotension following ROSC increases the probability of survival. 35–37…”

“…33 On the contrary, hemodynamic optimization through the prevention of hypotension following ROSC increases the probability of survival. [35][36][37] This study provides more data on the intermediate survival rate and neurological outcomes of IHCA patients in a low-income country. Our study provided evidence for factors affecting IHCA survival, which are mainly attributed to knowledge, skills, and equipment.…”