Hospital variation in survival trends for in-hospital cardiac arrest.
Bottom Line: Improvement in survival varied markedly and ranged from 3% in the bottom hospital quartile to 11% in the top hospital quartile.Compared with minor teaching hospitals (OR 1.04, 95% CI 1.02 to 1.06), hospital rate of survival improvement was greater at major teaching (OR 1.08, 95% CI 1.06 to 1.10) and nonteaching hospitals (OR 1.07, 95% CI 1.05 to 1.09, P value for interaction=0.03).Future studies are needed to identify hospital processes that have led to the largest improvement in survival.
Affiliation: University of Iowa Carver College of Medicine, Iowa City, IA (S.G.).Show MeSH
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Mentions: At baseline (ie, during the first year of participation in GWTG‐Resuscitation), the mean unadjusted hospital survival rate for in‐hospital cardiac arrest was 18.2%. Survival rates improved at 218 (94%) hospitals (ie, hospitals with estimate of slope >0), with a mean 4% improvement in survival per year (OR 1.04, 95% CI 1.03 to 1.05, P<0.001; Figure 2A and Table 3). Notably, the magnitude of improvement varied widely. Hospitals in the top quartile had a mean year‐over‐year survival improvement of 7%, while hospitals in the second and third hospital quartile had a mean year‐over‐year survival improvement of 5% and 3%, respectively. The mean year‐over‐year change in survival for hospitals in the lowest hospital quartile was 1%, suggesting little to no improvement in survival over time.
Affiliation: University of Iowa Carver College of Medicine, Iowa City, IA (S.G.).