• Matthew P Weber, Raymond J Strobel, Anthony V Norman, Abhinav Kareddy, Andrew Young, Steven Young, El MohebMohamadMDivision of Cardiothoracic Surgery, University of Virginia, Charlottesville, VA., Sean W W Noona, Alexander M Wisniewski, Mohammed Quader, Michael Mazzeffi, Leora T Yarboro, and Nicholas R Teman.
• Division of Cardiothoracic Surgery, University of Virginia, Charlottesville, VA.
• J. Thorac. Cardiovasc. Surg. 2024 Aug 20.

ObjectiveThe impact of Cardiac Surgical Unit - Advanced Life Support (CSU-ALS) training on failure to rescue after cardiac arrest (FTR-CA) is unknown. We hypothesized that institutional CSU-ALS certification would be associated with lower FTR-CA.MethodsPatients undergoing Society of Thoracic Surgeons (STS) index operations from 2020-2023 from a regional collaborative were analyzed. Each institution was surveyed regarding its status as a CSU-ALS certified center. Patients stratified by CSU-ALS certification were 1:1 propensity score matched with subsequent multivariable model reviewing associations with failure to rescue after cardiac arrest.ResultsA total of 12209 patients were included in the study period across 15 institutions. Eight centers reported CSU-ALS certification. After propensity score matching, two patient cohorts were formed (n = 3557). Patients at CSU-ALS centers had higher rates of ICU readmission (3.9% vs 2.3%, p<0.01) and total OR time (340 min vs 323 min, p<0.01). Hospital readmission was less likely in the CSU-ALS centers (9.0% vs 10.1%, p <0.01). There was no difference in the rate of post-operative cardiac arrest (1.8% vs 2.2 %, p = 0.24) or operative mortality (2.5% vs 2.9%, p = 0.30). After risk-adjustment, CSU-ALS centers (OR 0.30 [CI 0.12 - 0.72], p <0.01) and higher-volume centers (OR 0.15 [CI 0.03 - 0.74], p = 0.02) had reduced odds of FTR after cardiac arrest.ConclusionsCenters with CSU-ALS certification are associated with a lower risk-adjusted likelihood of FTR after cardiac arrest. This highlights the importance of well-trained staff and treatment algorithms in the care of post-operative cardiac surgery patients.Copyright © 2024. Published by Elsevier Inc.

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