Regional Variation in the Incidence and Outcomes of In-Hospital Cardiac Arrest in the United States
Regional Variation in the Incidence and Outcomes of In-Hospital Cardiac Arrest in the United States
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DOI：
10.1161/circulationaha.114.014542
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发表时间：
2015-04-21
期刊：
影响因子：
37.8
通讯作者：
Fonarow, Gregg C.
中科院分区：
文献类型：
--
作者：
Kolte, Dhaval;Khera, Sahil;Fonarow, Gregg C.
背景 - 院内心脏骤停 (IHCA) 的发生率和结果的区域差异尚未得到充分研究，可能具有重要的健康和政策影响。方法和结果 - 我们使用 2003 年至 2011 年全国住院患者样本数据库来识别年龄 >= 18 岁并接受心肺复苏的患者（国际疾病分类，第九版，临床修改程序代码 99.60 和 99.63），以进行心肺复苏。免疫组化协会。分析了 IHCA 发生率、出院生存率和资源利用（住院总费用和幸存者出院处置）的区域差异。在 838 465 例 IHCA 患者中，162 270 例（19.4%）位于东北部，159 581 例（19.0%）位于中西部，316 201 例（37.7%）位于南部，200 413 例（23.9%）位于西部。在美国，IHCA 的总体发生率为每 1000 名住院患者中有 2.85 例。 IHCA 发生率在中西部最低，在西部最高（分别为每 1000 名住院患者 2.33 例和 3.73 例）。与东北部相比，中西部（比值比，1.33；95% 置信区间，1.31-1.36）、南部（比值比，1.21；95% 置信区间，1.19-1.23）和西部（比值比，1.25；95% 置信区间，1.23-1.27）的风险调整出院生存率显着较高。从 2003 年到 2011 年，美国和所有地区的 IHCA 生存率显着增加（所有 P 趋势
Background-Regional variation in the incidence and outcomes of in-hospital cardiac arrest (IHCA) is not well studied and may have important health and policy implications.Methods and Results-We used the 2003 to 2011 Nationwide Inpatient Sample databases to identify patients >= 18 years of age who underwent cardiopulmonary resuscitation (International Classification of Diseases, Ninth Edition, Clinical Modification procedure codes 99.60 and 99.63) for IHCA. Regional differences in IHCA incidence, survival to hospital discharge, and resource use (total hospital cost and discharge disposition among survivors) were analyzed. Of 838 465 patients with IHCA, 162 270 (19.4%) were in the Northeast, 159 581 (19.0%) were in the Midwest, 316 201 (37.7%) were in the South, and 200 413 (23.9%) were in the West. Overall IHCA incidence in the United States was 2.85 per 1000 hospital admissions. IHCA incidence was lowest in the Midwest and highest in the West (2.33 and 3.73 per 1000 hospital admissions, respectively). Compared with the Northeast, risk-adjusted survival to discharge was significantly higher in the Midwest (odds ratio, 1.33; 95% confidence interval, 1.31-1.36), South (odds ratio, 1.21; 95% confidence interval, 1.19-1.23), and West (odds ratio, 1.25; 95% confidence interval, 1.23-1.27). IHCA survival increased significantly from 2003 to 2011 in the United States and in all regions (all P-trend