Open AccessImpact of Transport Time and Cardiac Arrest Centers on the Neurological Outcome After Out‐of‐Hospital Cardiac Arrest: A Retrospective Cohort Study
Author(s) -
Chien ChengYu,
Tsai ShangLi,
Tsai LiHeng,
Chen ChenBin,
Seak ChenJune,
Weng YiMing,
Lin ChiChun,
Ng ChipJin,
Chien WeiChe,
Huang ChienHsiung,
Lin ChengYu,
Chaou ChungHsien,
Liu PengHuei,
Tseng HsiaoJung,
Fang ChiTai
Publication year - 2020
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.119.015544
Subject(s) - medicine , odds ratio , hospital discharge , propensity score matching , retrospective cohort study , emergency medicine , cardiology
Background Should all out‐of‐hospital cardiac arrest ( OHCA ) patients be directly transported to cardiac arrest centers ( CAC s) remains under debate. Our study evaluated the impacts of different transport time and destination hospital on the outcomes of OHCA patients. Methods and Results Data were collected from 6655 OHCA patients recorded in the regional prospective OHCA registry database of Taoyuan City, Taiwan, between January 2012 and December 2016. Patients were matched on propensity score, which left 5156 patients, 2578 each in the CAC and non‐ CAC groups. Transport time was dichotomized into <8 and ≥8 minutes. The relations between the transport time to CAC s and good neurological outcome at discharge and survival to discharge were investigated. Of the 5156 patients, 4215 (81.7%) presented with nonshockable rhythms and 941 (18.3%) presented with shockable rhythms. Regardless of transport time, transportation to a CAC increased the likelihoods of survival to discharge (<8 minutes: adjusted odds ratio [aOR], 1.95; 95% CI, 1.11–3.41; ≥8 minutes: aOR, 1.92; 95% CI, 1.25–2.94) and good neurological outcome at discharge (<8 minutes: aOR, 2.70; 95% CI, 1.40–5.22; ≥8 minutes: aOR, 2.20; 95% CI, 1.29–3.75) in OHCA patients with shockable rhythms but not in patients with nonshockable rhythms. Conclusions OHCA patients with shockable rhythms transported to CAC s demonstrated higher probabilities of survival to discharge and a good neurological outcome at discharge. Direct ambulance delivery to CAC s should thus be considered, particularly when OHCA patients present with shockable rhythms.