Abstract 17981: Regional Differences in Outcomes After Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest in the United States
Background: Regional disparities in outcomes after out-of-hospital cardiac arrest have been described. However, whether such differences exist in outcomes after in-hospital cardiac arrest (IHCA) has not been well studied.
Objectives: To determine if outcomes after cardiopulmonary resuscitation (CPR) for IHCA differ across geographic regions in the United States.
Methods: We used the 2003-2011 Nationwide Inpatient Sample databases to identify all patients aged ≥18 years who underwent CPR (ICD-9-CM procedure codes 99.60 and 99.63) for IHCA. Patients were divided into 4 groups according to hospital region [[Unable to Display Character: –]] Northeast, Midwest, South, and West. Multivariable logistic regression analysis was used to identify differences in outcomes (survival to hospital discharge, neurological status, and total hospital cost) among the 4 regions.
Results: Of 838,951 patients who received CPR for IHCA, 162,290 (19.3%) were in the Northeast, 159,777 (19%) in Midwest, 316,363 (37.7%) in South, and 200,522 (23.9%) in West. Compared to Northeast, patients in Midwest, South and West were more likely to have a primary diagnosis of acute myocardial infarction, and ventricular tachycardia/ventricular fibrillation as the initial cardiac arrest rhythm (p<0.001). Compared to Northeast, adjusted rate of survival to hospital discharge was significantly higher in Midwest, West and South (Table 1). Patients in South and West were more likely to have a poor neurological status after IHCA, as compared to Northeast (Table 1). Total hospital cost in patients with IHCA was highest in the West (Table 1).
Conclusion: We observed significant geographic variation in outcomes after CPR for IHCA within the United States. Differences in demographics, co-morbidities, and hospital characteristics do not completely explain the differences in outcomes. Further studies are needed to identify the factors responsible for these regional differences in order to improve outcomes after IHCA.
Author Disclosures: D. Kolte: None. S. Khera: None. M. Mujib: None. C. Palaniswamy: None. S. Pinnamaneni: None. W.S. Aronow: None. S. Iwai: None. P. Eugenio: None. S. Lessner: None. D. Jain: None. S. Sule: None. A. Ahmed: None. D.L. Bhatt: None. G.C. Fonarow: None. H.A. Cooper: None. J.A. Panza: None.
- © 2014 by American Heart Association, Inc.