Choice of hospital after out-of-hospital cardiac arrest - a decision with far-reaching consequences: a study in a large German city

• DOI: 10.1186/cc11516
• Publication Date: 2012-09-12T21:56:21Z
• Authors: Jan Wnent; Stephan Seewald; Matthias Heringlake; Hans Lemke; Kirk Brauer; Rolf Lefering; Matthias Fischer; Tanja Jantzen; Berthold Bein; Martin Messelken; Jan-Thorsten Gräsner
• Keywords: Hospital discharge

Between 1 and 31% of patients suffering out-of-hospital cardiac arrest (OHCA) survive to discharge from hospital. International studies have shown that the level care provided by admitting hospital determines survival for OHCA. These data may only be partially transferable German medical system where responders are in-field emergency physicians. The present study influence physician's choice on patient outcome after OHCA in a large urban setting.All collected Resuscitation Registry city Dortmund during 2007 2008 were analyzed. Patients under 18 years age, with traumatic mechanism, incomplete charts excluded. Admitting hospitals divided into two groups: those without capability percutaneous coronary intervention (PCI), PCI capability. Data analyzed multivariate statistics, taking account effects mild therapeutic hypothermia treatment respect neurological status upon discharge.Between total 1,109 cardiopulmonary resuscitation attempts registered Dortmund, which 889 could included our study. Return spontaneous circulation was achieved 360 (40.5%). In total, 282 displayed return transport (31.7%); 152 transported ongoing (17.1%). Of 434 admitted hospital, 264 170 Multivariate analysis demonstrated significant good (odds ratio 3.14 (95% confidence interval 1.51 6.56)), independent receiving and/or PCI. Compared capability, significantly more discharged alive (41% vs. 13%, P < 0.001) remained year event (28% 6%, 0.001).The influences outcome. This is performance hypothermia. Further required determine possible parameters determining