-
Multicenter Study Observational Study
Accredited Cardiac Arrest Centers Facilitate eCPR and Improve Neurological Outcome.
- Fabian Voß, Tharusan Thevathasan, Karl Heinrich Scholz, Bernd W Böttiger, Daniel Scheiber, Payam Kabiri, Michael Bernhard, Peter Kienbaum, Christian Jung, Ralf Westenfeld, Carsten Skurk, Christoph Adler, and Malte Kelm.
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine University Düsseldorf, Medical Faculty, Moorenstr. 5, 40225 Düsseldorf, Germany.
- Resuscitation. 2024 Jan 1; 194: 110069110069.
BackgroundOut-of-hospital cardiac arrest (OHCA) remains a frequent medical emergency with low survival rates even after a return of spontaneous circulation (ROSC). Growing evidence supports formation of dedicated teams in scenarios like cardiogenic shock to improve prognosis. Thus, the European Resuscitation Council (ERC) recommended introduction of Cardiac Arrest Centers (CAC) in their 2015 guidelines. Here, we aimed to elucidate the effects of newly introduced CACs in Germany regarding survival rate and neurological outcome.MethodsA multicenter retrospective observational cohort study was performed at three university hospitals and outcomes after OHCA were compared before and after CAC accreditation. Primary outcomes were survival until discharge and favorable neurological status (CPC 1 or 2) at discharge.ResultsIn total 784 patients (368 before and 416 after CAC accreditation) were analyzed. Rates of immediate percutaneous coronary intervention (40 vs. 52%, p = 0.01) and implementation of extracorporeal CPR (8 vs. 13%, p < 0.05) increased after CAC accreditation. Likelihood of favorable neurological status at discharge was higher after CAC accreditation (71 vs. 87%, p < 0.01), whereas overall survival remained similar (35 vs. 35%, p > 0.99).ConclusionCAC accreditation is linked to higher rates of favorable neurological outcome and unchanged overall survival.Copyright © 2023. Published by Elsevier B.V.
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