• Uchenna R Ofoma, Anne M Drewry, Thomas M Maddox, Walter Boyle, Elena Deych, Marin Kollef, Saket Girotra, Karen E Joynt Maddox, and American Heart Association's Get With The Guidelines®- Resuscitation Investigators.
• Division of Critical Care Medicine, Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA. Electronic address: uofoma@wustl.edu.
• Resuscitation. 2022 Aug 1; 177: 7157-15.

BackgroundSurvival rates following in-hospital cardiac arrest (IHCA) are lower during nights and weekends (off-hours), as compared to daytime on weekdays (on-hours). Telemedicine Critical Care (TCC) may provide clinical support to improve IHCA outcomes, particularly during off-hours.ObjectiveTo evaluate the association between hospital availability of TCC and IHCA survival.MethodsWe identified 44,585 adults at 280 U.S. hospitals in the Get With The Guidelines® - Resuscitation registry who suffered IHCA in an Intensive Care Unit (ICU) or hospital ward between July 2017 and December 2019. We used 2-level hierarchical multivariable logistic regression to investigate whether TCC availability was associated with better survival, overall, and during on-hours (Monday-Friday 7:00 a.m.-10:59p.m.) vs. off-hours (Monday-Friday 11:00p.m.-6:59 a.m., and Saturday-Sunday, all day, and US national holidays).Results14,373 (32.2%) participants suffered IHCA at hospitals with TCC, and 27,032 (60.6%) occurred in an ICU. There was no difference between TCC and non-TCC hospitals in acute resuscitation survival rate or survival to discharge rates for either IHCA occurring in the ICU (acute survival odds ratio [OR] 1.02, 95% CI 0.92-1.15; survival to discharge OR 0.94 [0.83-1.07]) or outside of the ICU (acute survival OR 1.03 [0.91-1.17]; survival to discharge OR 0.99 [0.86-1.12]. Timing of cardiac arrest did not modify the association between TCC availability and acute resuscitation survival (P =.37 for interaction) or survival to discharge (P =.39 for interaction).ConclusionsHospital availability of TCC was not associated with improved outcomes for in-hospital cardiac arrest.Copyright © 2022 Elsevier B.V. All rights reserved.

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