Inter-hospital trends of post-resuscitation interventions and outcomes of out-of-hospital cardiac arrest in Singapore-Reference-Cited by-同舟云学术

Inter-hospital trends of post-resuscitation interventions and outcomes of out-of-hospital cardiac arrest in Singapore

Published:2022-06-28 Issue:6 Volume:51 Page:341-350
ISSN:0304-4602
Container-title:Annals of the Academy of Medicine, Singapore
language:en
Short-container-title:Ann Acad Med Singap

Author:

Jaffar Julia Li Yan¹,Fook-Chong Stephanie²,Shahidah Nur³,Ho Andrew Fu Wah²,Ng Yih Yng⁴,Arulanandam Shalini⁵,White Alexander⁵,Liew Le Xuan⁵,Asyikin Nurul⁵,Leong Benjamin Sieu-Hon⁶,Gan Han Nee⁷,Mao Desmond⁸,Chia Michael Yih Chong⁴,Cheah Si Oon⁹,Ong Marcus Eng Hock³

Affiliation:

1. Ministry of Health Holdings, Singapore

2. Duke-NUS Medical School, Singapore

3. Singapore General Hospital, Singapore

4. Tan Tock Seng Hospital, Singapore

5. Singapore Civil Defence Force, Singapore

6. National University Hospital, Singapore

7. Changi General Hospital, Singapore

8. Khoo Teck Puat Hospital, Singapore

9. Ng Teng Fong General Hospital, Singapore

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 postresuscitation 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. Keywords: Out-of-hospital cardiac arrest, percutaneous coronary intervention, post-resuscitation care, resuscitation, targeted temperature management

Publisher

Academy of Medicine, Singapore

Subject

General Medicine

Reference40 articles.

1. Berdowski J, Berg RA, Tijssen JG, et al. Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies. Resuscitation 2010;81:1479-87.

2. Sharabi AF, Singh A. Cardiopulmonary arrest in adults. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. Available at: https://www.ncbi.nlm.nih.gov/books/NBK563231/. Accessed on 18 April 2022.

3. Cummins RO. Emergency medical services and sudden cardiac arrest: the “chain of survival” concept. Annu Rev Public Health 1993;14:313-33.

4. Rao P, Kern KB. Improving community survival rates from out-of-hospital cardiac arrest. Curr Cardiol Rev 2018;14:79-84.

5. Yamaguchi Y, Woodin JA, Gibo K, et al. Improvements in out-of-hospital cardiac arrest survival from 1998 to 2013. Prehosp Emerg Care 2017;21:616-27.