Regional Variation in Out-of-Hospital Cardiac Arrest Incidence and Outcome
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A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
No Canadian affiliation. An affiliation-only frame — the usual design — would never have seen this work. It is one of the works that make the case for inverting the frame.
Abstract
CONTEXT: The health and policy implications of regional variation in incidence and outcome of out-of-hospital cardiac arrest remain to be determined. OBJECTIVE: To evaluate whether cardiac arrest incidence and outcome differ across geographic regions. DESIGN, SETTING, AND PATIENTS: Prospective observational study (the Resuscitation Outcomes Consortium) of all out-of-hospital cardiac arrests in 10 North American sites (8 US and 2 Canadian) from May 1, 2006, to April 30, 2007, followed up to hospital discharge, and including data available as of June 28, 2008. Cases (aged 0-108 years) were assessed by organized emergency medical services (EMS) personnel, did not have traumatic injury, and received attempts at external defibrillation or chest compressions or resuscitation was not attempted. Census data were used to determine rates adjusted for age and sex. MAIN OUTCOME MEASURES: Incidence rate, mortality rate, case-fatality rate, and survival to discharge for patients assessed or treated by EMS personnel or with an initial rhythm of ventricular fibrillation. RESULTS: Among the 10 sites, the total catchment population was 21.4 million, and there were 20,520 cardiac arrests. A total of 11,898 (58.0%) had resuscitation attempted; 2729 (22.9% of treated) had initial rhythm of ventricular fibrillation or ventricular tachycardia or rhythms that were shockable by an automated external defibrillator; and 954 (4.6% of total) were discharged alive. The median incidence of EMS-treated cardiac arrest across sites was 52.1 (interquartile range [IQR], 48.0-70.1) per 100,000 population; survival ranged from 3.0% to 16.3%, with a median of 8.4% (IQR, 5.4%-10.4%). Median ventricular fibrillation incidence was 12.6 (IQR, 10.6-5.2) per 100,000 population; survival ranged from 7.7% to 39.9%, with a median of 22.0% (IQR, 15.0%-24.4%), with significant differences across sites for incidence and survival (P<.001). CONCLUSION: In this study involving 10 geographic regions in North America, there were significant and important regional differences in out-of-hospital cardiac arrest incidence and outcome.
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The record
- Venue
- JAMA
- Topic
- Cardiac Arrest and Resuscitation
- Field
- Medicine
- Canadian institutions
- —
- Funders
- National Institute of Neurological Disorders and StrokeNational Heart, Lung, and Blood Institute
- Keywords
- MedicineVentricular fibrillationInterquartile rangeDefibrillationVentricular tachycardiaPopulationIncidence (geometry)Cardiopulmonary resuscitationResuscitationCase fatality rateEmergency medicineInternal medicineCardiologyEpidemiology
- Has abstract in OpenAlex
- yes