Abstract 16121: The Decade of Change: Survival Following Out-of-hospital Cardiac Arrest in Teaching versus Nonteaching Hospitals in the United States: 2000-2012
Background: All hospitals, regardless of teaching status, need to provide care for OHCA patients. Whether outcomes differ in teaching vs nonteaching hospitals is unknown and was examined in this study.
Methods: Using the National Inpatient Sample database, we selected adults ≥18 years old admitted with a principle diagnosis of non-traumatic OHCA (ICD-9 CM codes 427.5 & 427.41) between 2000 and 2012. Patients were stratified to teaching (THs) or nonteaching hospitals (NTHs). The association of hospital teaching status with length of stay, total charges/case, survival to discharge, and survival with good neurologic outcome was assessed by multivariate logistic regression or generalized linear regression models, adjusting for patient and hospital-level characteristics.
Results: Of 186,483 admitted patients, 86,053 (46.15%) were treated at teaching hospitals during the study period. Overall OHCA incidence in the United States was 3.86 per 10,000 hospital admissions. Patients at teaching hospitals were more often younger, more likely to have VF, and less likely to be Caucasian [all p < 0.001] but with a similar comorbidity burden. Mean length of stay and total charges were higher in teaching hospitals (5 vs. 4 days, p<0.01 & $72,436 vs. $52,917, p<0.01). Risk-adjusted survival and survival with good neurologic outcome were significantly better in THs as compared to NTHs (odds ratio, 1.06; 95% CI 1.02 – 1.14 & 1.19; 95% CI 1.09 – 1.29 respectively). Despite a significant increase in OHCA survival at NTHs between 2000 and 2012 (Ptrend<0.01), OHCA survival rate at THs remained higher without any change in trend (Ptrend=0.07) during the study period.
Conclusion: For OHCA patients in the US, survival has been consistently higher in teaching hospitals. However, a dramatic improvement in survival has been realized in nonteaching hospitals over the last 12 years with lesser healthcare expenditure when compared to teaching hospitals; this phenomenon is worthy of further study.
Author Disclosures: S.M. Eid: None. A. Albaeni: None. B. Akinyele: None. L.N. Raghavakurup: None. N. Chandra-Strobos: None.
- © 2015 by American Heart Association, Inc.