Posted on 05/31/2016

A peer-reviewed article utilizing CARES data entitled "Regional Variation in Out-of-Hospital Cardiac Arrest Survival in the United States" was recently published in Circulation. The abstract and PubMed link can be found below. 

BACKGROUND: 
Although previous studies have shown marked variation in out-of-hospital cardiac arrest survival across U.S. regions, factors underlying this survival variation remain incompletely explained. 

METHODS AND RESULTS: 
Using data from the Cardiac Arrest Registry to Enhance Survival, we identified 96,662 adult patients with out-of-hospital cardiac in 132 U.S. counties. We used hierarchical regression models to examine county-level variation in rates of survival and survival with functional recovery (defined as Cerebral Performance Category score of 1 or 2) and examined the contribution of demographics, cardiac arrest characteristics, bystander cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) use, and county-level socio-demographic factors in survival variation across counties. A total of 9317 (9.6%) patients survived to discharge, and 7176 (7.4%) achieved functional recovery. At a county-level, there was marked variation in rates of survival to discharge (range: 3.4%-22.0%, median odds ratio [MOR] 1.40, 95% CI 1.32-1.46) and survival with functional recovery (range: 0.8%-21.0%, MOR 1.53, 95% CI 1.43-1.62). County-level rates of bystander CPR and AED use were positively correlated with both outcomes (P<0.0001 for all). Patient demographic and cardiac arrest characteristics explained 4.8% and 27.7% of the county-level variation in survival, respectively. Additional adjustment of bystander CPR and AED explained 41% of the survival variation, and this increased to 50.4% after adjustment of county-level socio-demographic factors. Similar findings were noted in analyses of survival with functional recovery. 

CONCLUSIONS: 
Although out-of-hospital cardiac arrest survival varies significantly across U.S. counties, a substantial proportion of the variation is due to differences in bystander response across communities. 

PubMed link:
http://www.ncbi.nlm.nih.gov/pubmed/27081119

SOURCE: Cardiac Registry to Enhance Survival

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