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More patients survive in-hospital cardiac arrest


Survival in patients who experience a cardiac arrest in the hospital has increased significantly over the past decade, according to a study. The improvement has been accompanied by lower rates of neurological disability among survivors.

Applying the study results to the approximately 200,000 patients who suffer cardiac arrest each year, researchers estimated an additional 17,200 patients survived and 13,000 fewer patients suffered neurological disabilities in 2009 compared with 2000, said Saket Girotra, MD, the study’s lead author and an associate in internal medicine at the University of Iowa Hospitals and Clinics.

“We are not only seeing an improvement in quantity of life, but also quality of life among survivors at the time of discharge,” Girotra said in a news release.

Researchers with UI, Saint Luke’s Mid America Heart Institute and the University of Missouri, Kansas City, examined almost 85,000 patients who experienced a cardiac arrest while hospitalized over a 10-year period from 2000 to 2009. The team found that the risk-adjusted rate of survival among these patients increased from 13.7% in 2000 to 22.3% in 2009. The increase in survival over time was due to both a greater success in reviving patients from the initial cardiac arrest event and an improvement in survival following successful resuscitation until discharge.

Neurological damage that occurs during a cardiac arrest can lead to a significant disability and reduced quality of life. The researchers wondered whether improved survival came at a cost of increased neurological disability among the survivors, but the data showed that neurological disability decreased from 32.9% in 2000 to 28.1% in 2009.

The study focused on patients at 374 hospitals participating in the “Get with the Guidelines-Resuscitation” registry, a large national quality-improvement registry overseen by the American Heart Association. The program aims to help healthcare teams consistently use evidence-based best practices to improve patient outcomes and is among a number of quality improvement strategies hospitals have implemented to improve myocardial infarction survival rates in inpatient settings.

Although the study did not pinpoint which specific factors are responsible for the improvement in survival, Girotra said the findings suggest an overall improvement in quality of resuscitation care. He said a greater understanding of the factors behind the increased survival rates will allow the benefits to be consolidated and expanded to all hospitals.

The study appears in the Nov. 15 issue of the New England Journal of Medicine. The study abstract is available at


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