Chances of surviving cardiac arrest better in bigger hospitals

January 10th, 2009 - 1:26 pm ICT by IANS  

Washington, Jan 10 (IANS) People who go through cardiac arrest have better chances of survival in large, urban and teaching hospitals, according to a recent study.Chances of survival are better still if such patients are treated in the highest volume intensive care units (ICU), suggests another study.

There is a need to explore the development of specialised, regional post-cardiac arrest care centres modelled on trauma centres, said study co-author Brendan Carr, assistant professor of emergency medicine and epidemiology, University of Pennsylvania School of Medicine.

These findings were published recently in Intensive Care Medicine and Resuscitation.

Carr’s findings also underscore the importance of the recent move by New York City to require ambulances to take cardiac arrest patients to hospitals that provide therapeutic hypothermia.

Hypothermia is the so-called “cooling” therapy that protects against damage to the brain and other organs in the crucial hours after the heart is restored to its normal rhythm - even if those facilities are further away.

“There are two possible implications: Either we need to get everyone up to speed on how to optimise survival, or we need to selectively transfer patients to hospitals that have expertise in the post-arrest period,” said Carr.

The two studies, which examined a combined 115,000 cases in two different national datasets, also point to an overall improvement in cardiac arrest care.

Over the course of the five years of study, the authors found a reduction in mortality that implies 11,000 more lives saved per year - a significant decrease for a condition that is typically fatal.

Better survival odds are multifactorial, but likely related to advances in critical care, the recognition of the role of hypothermia, and the creation of national guidelines for post-cardiac arrest care, said a Pennsylvania release.

“There has been a fundamental shift such that we now recognise the condition patients experience after cardiac arrest as a treatable disease,” said co-author Robert Neumar, associate professor of emergency medicine.

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