Duration of hospital participation in Get With the Guidelines-Resuscitation and survival of in-hospital cardiac arrest.
Duration of hospital participation in Get With the Guidelines-Resuscitation and survival of in-hospital cardiac arrest.
复制标题
DOI：
10.1016/j.resuscitation.2012.03.014
复制
发表时间：
2012-11
期刊：
影响因子：
6.5
通讯作者：
Nichol G
中科院分区：
文献类型：
--
作者：
Bradley SM;Huszti E;Warren SA;Merchant RM;Sayre MR;Nichol G
Get With the Guidelines （GWTG-R）是一项针对院内心脏骤停（IHCA）的数据登记和质量改进计划。目前尚不清楚参与GWTG-R的住院时间是否与IHCA结果相关。我们分析了2000年至2009年间参与GWTG-R的362家医院中患有IHCA的成年人。使用逻辑回归和广义估计方程来解释医院的聚类，我们确定了医院参与GWTG-R的时间与IHCA后患者结局之间的关系，并根据患者和骤停特征以及长期趋势进行了调整。使用这些方法，我们还评估了参与时间与先前与IHCA后生存相关的因素之间的关系，包括ECG监测状态、小时后骤停和除颤时间。104,732例IHCA患者中，17,646例（16.9%）存活至出院。参与GWTG-R的住院时间与IHCA事件生存率相关（每年参与，比值比[OR] 1.02; 95% CI 1.00-1.04; p = 0.046），但与出院生存率无关（OR 1.02; 95% CI 0.99-1.04; p = 0.18）。在先前与IHCA生存相关的因素中，参与时间与除颤时间≤2分钟（每年参与，OR 1.06; 95% CI 1.03-1.10; p < 0.001）相关，但与ECG监测状态（OR 1.00; 95% CI 0.93-1.06; p = 0.90）或小时后骤停存活（OR 1.01; 95% CI 0.99-1.03; p = 0.41）无关。在室性心动过速或心室颤动（VT/VF）骤停中，除颤时间减弱了住院时间与结果之间的关联。参与GWTG-R的住院时间与IHCA事件的生存率显著相关，但与出院生存率无关。在VT/VF骤停中，这种关联可能是由除颤时间的改善所介导的。
Get With the Guidelines (GWTG-R) is a data registry and quality improvement program for in-hospital cardiac arrest (IHCA). It is unknown if duration of hospital participation in GWTG-R is associated with IHCA outcomes. We analyzed adults with IHCA from 362 hospitals participating in GWTG-R between 2000 and 2009. Using logistic regression with generalized estimating equations to account for clustering on hospital, we determined the association between duration of hospital participation in GWTG-R and patient outcomes after IHCA, adjusted for patient and arrest characteristics and secular trend. Using these methods, we also evaluated the association between duration of participation and factors previously correlated with survival after IHCA, including ECG monitored status, after-hours arrest, and time to defibrillation. Of 104,732 patients with IHCA, 17,646 patients (16.9%) survived to discharge. Duration of hospital participation in GWTG-R was associated with IHCA event survival (per year of participation, odds ratio [OR] 1.02; 95% CI 1.00–1.04; p = 0.046) but not survival to discharge (OR 1.02; 95% CI 0.99–1.04; p = 0.18). Among factors previously correlated with IHCA survival, duration of participation was associated with time to defibrillation ≤2 min (per year of participation, OR 1.06; 95% CI 1.03–1.10; p < 0.001), but not ECG monitored status (OR 1.00; 95% CI 0.93–1.06; p = 0.90) or survival of after-hours arrest (OR 1.01; 95% CI 0.99–1.03; p = 0.41). Among ventricular tachycardia or ventricular fibrillation (VT/VF) arrests, time to defibrillation attenuated the association between duration of hospital participation and outcomes. Duration of hospital participation in GWTG-R was significantly associated with survival of the IHCA event, but not with survival to discharge. In VT/VF arrests, this association may have been mediated by improvements in time to defibrillation.
登录
查看更多内容
影响因子：
11.4
作者：
Bristow, PJ;Hillman, KM;Simmons, EG
通讯作者：
Simmons, EG
影响因子：
158.5
作者：
Chan, Paul S.;Krumholz, Harlan M.;Nallamothu, Brahmajee K.
通讯作者：
Nallamothu, Brahmajee K.
影响因子：
4.8
作者：
Heidenreich, Paul A.;Lewis, William R.;Fonarow, Gregg C.
通讯作者：
Fonarow, Gregg C.
影响因子：
6.5
作者：
Coady, EM
通讯作者：
Coady, EM
影响因子：
158.5
作者：
Bernard, SA;Gray, TW;Smith, K
通讯作者：
Smith, K