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Inter-hospital trends of post-resuscitation interventions and outcomes of out-of-hospital cardiac arrest in Singapore
Article de En | WPRIM | ID: wpr-939546
Bibliothèque responsable: WPRO
ABSTRACT
INTRODUCTION@#Hospital-based resuscitation interventions, such as therapeutic temperature management (TTM), emergency percutaneous coronary intervention (PCI) and extracorporeal membrane oxygenation (ECMO) can improve outcomes in out-of-hospital cardiac arrest (OHCA). We investigated post-resuscitation interventions and hospital characteristics on OHCA outcomes across public hospitals in Singapore over a 9-year period.@*METHODS@#This was a prospective cohort study of all OHCA cases that presented to 6 hospitals in Singapore from 2010 to 2018. Data were extracted from the Pan-Asian Resuscitation Outcomes Study Clinical Research Network (PAROS CRN) registry. We excluded patients younger than 18 years or were dead on arrival at the emergency department. The outcomes were 30-day survival post-arrest, survival to admission, and neurological outcome.@*RESULTS@#The study analysed 17,735 cases. There was an increasing rate of provision of TTM, emergency PCI and ECMO (P<0.001) in hospitals, and a positive trend of survival outcomes (P<0.001). Relative to hospital F, hospitals B and C had lower provision rates of TTM (≤5.2%). ECMO rate was consistently <1% in all hospitals except hospital F. Hospitals A, B, C, E had <6.5% rates of provision of emergency PCI. Relative to hospital F, OHCA cases from hospitals A, B and C had lower odds of 30-day survival (adjusted odds ratio [aOR]<1; P<0.05 for hospitals A-C) and lower odds of good neurological outcomes (aOR<1; P<0.05 for hospitals A-C). OHCA cases from academic hospitals had higher odds ratio (OR) of 30-day survival (OR 1.3, 95% CI 1.1-1.5) than cases from hospitals without an academic status.@*CONCLUSION@#Post-resuscitation interventions for OHCA increased across all hospitals in Singapore from 2010 to 2018, correlating with survival rates. The academic status of hospitals was associated with improved survival.
Sujet(s)
Texte intégral: 1 Indice: WPRIM Sujet Principal: Singapour / Études prospectives / Arrêt cardiaque hors hôpital / Intervention coronarienne percutanée / Hôpitaux publics Type d'étude: Observational_studies Limites du sujet: Humans Pays comme sujet: Asia langue: En Texte intégral: Ann. Acad. Med. Singap. (Online) Année: 2022 Type: Article
Texte intégral: 1 Indice: WPRIM Sujet Principal: Singapour / Études prospectives / Arrêt cardiaque hors hôpital / Intervention coronarienne percutanée / Hôpitaux publics Type d'étude: Observational_studies Limites du sujet: Humans Pays comme sujet: Asia langue: En Texte intégral: Ann. Acad. Med. Singap. (Online) Année: 2022 Type: Article