Abstract 44: Outcomes of OHCA Not Improved After New Guideline Implementation in Taiwan: Nationwide Population-Based Research Using National Health Insurance Data
Background: Survival after out-of-hospital cardiac arrest (OHCA) depends on the integrity of the community chain of survival, including high quality CPR, early defibrillation, better hospital and post-resuscitation care. Recent studies from US showed the outcomes from OHCAs improved significantly after implementation of new resuscitation guideline. Our study, by using the population- based National Health Insurance data, was aimed to assess the factors associated patient outcomes and the improvement after guidelines 2005 implementation in Taiwan.
Methods: From the claim data of one million beneficiaries of Taiwan National Health Insurance during the year of 2005 to 2008, all of patients who were sent to emergency department with diagnosis of OHCA were identified from the database (ICD 798, 798.1, 798.2, 798.9). Traumatic OHCA and patients without codes for intubation and CPR were excluded in our study. Factors such as age, gender, preexisting co-morbidities and different hospital levels were adjusted in a logistic regression model for survival analysis. All the survival cases were followed up for one year in our data-set.
Results: 2,375 OHCA cases were identified from the four-year dataset. The survival rates were 7.3%(2005), 7.5%(2006), 7.2%(2007) and 6.5%(2008) (p>0.05). And the survival rates was 7.4% in medical centers, 7.8% in regional hospitals and 5.0% in district hospitals (p>0.05). In the logistic regression analysis model, for all the OHCA patients admitted to ER and to hospitals, none of the factors (including the age, gender, preexisting co-morbidities and different hospital levels) were significant for survival.
Conclusions: After adjusting for age, gender and preexisting co-morbidities, our study shows that OHCA patients had equal outcomes between medical centers and non-medical centers. And our data also showed non-significant outcome improvement after guidelines 2005 implementation in Taiwan.
- © 2012 by American Heart Association, Inc.