Abstract 17183: Association Between Level of Hospital Resources for Out-of-Hospital Cardiac Arrest and Outcome in Gyeonggi Province
Introduction: Post arrest care is important for favorable outcome in cardiac arrest. There are growing evidences about advantages of regionalization in the system of care for the out-of-hospital cardiac arrest (OHCA).
Hypothesis: In this study, we aimed to categorize cardiac arrest care centers (CAC) according to their level of resources and verify if there are outcome differences in Gyeonggi Province, South Korea.
Methods: This is an observational study performed in Gyeonggi (approximately 12 million of population). Survey via email was conducted to all 90 hospitals where OHCAs were transferred from 2013 to 2014 by EMS. Questionnaire included resources, standardized cardiac arrest management strategies and quality management statements. Hospitals were categorized into 3 groups based on the result of the survey. Definite CAC (D-CAC) was defined as a comprehensive center where multidisciplinary approach and post arrest care could be provided. Primary CAC (P-CAC) was defined as a center with a standardized cardiac arrest resuscitation and transfer protocol. None CAC(N-CAC) was defined as neither of the two. Good neurologic outcome (defined as cerebral performance category 1-2) was compared using Nationwide OHCA data base constructed by Korean CDC.
Results: From total 90 CACs in Gyeonggi, 77 centers replied to the survey. Fifteen centers were categorized as D-CAC, 32 centers as P-CAC and 30 centers as N-CAC. Total 11,941 OHCAs were transferred to hospitals by EMS during study period and 10,212 patients to CACs where replied to the survey. Among them 4342 (42.9%) were transferred to D-CAC, 2906 (28.7%) to P-CAC and 2873 (28.4%) to N-CAC. D-CAC showed better neurologic outcome (5.0%) than P-CAC (1.6%, p<0.001) or N-CAC (0.8%, p<0.001). Adjusted OR (95% CI) for good neurologic recovery was 2.82 (95%CI 2.19-3.62) in D-CAC and 0.87 (95% CI 0.63-1.20) in N-CAC compared to P-CAC.
Conclusions: About 57% of OHCAs occurred in Gyeonggi were transferred to non D-CAC. There was significant difference in favorable neurologic outcome between D-CAC and others centers. Further study is needed to define the causes of difference and implement measures including regionalization of system of care.
Author Disclosures: K. Joo-yeong: None. S. Moon: None. J. Park: None. S. Shin: None. Y. Ro: None. E. Lee: None. K. Ahn: None. W. Jeon: None. J. Park: None. D. Wi: None. J. Joo: None. K. Lee: None.
- © 2016 by American Heart Association, Inc.