Dataset Information

Long-Term Outcomes for Out-of-Hospital Cardiac Arrest in Elderly Patients: An Analysis of Cardiac Arrest Registry to Enhance Survival Data Linked to Medicare Files.

ABSTRACT:

Background

Most studies on out-of-hospital cardiac arrest have primarily focused on in-hospital or short-term survival. Little is known about long-term outcomes and resource use among survivors of out-of-hospital cardiac arrest.

Methods

In this observationsl study, we describe overall long-term outcomes for patients from the national Cardiac Arrest Registry to Enhance Survival linked to Medicare files to create the Cardiac Arrest Registry to Enhance Survival: Mortality, Events, and Costs for Cardiac Arrest survivors dataset. Cardiac Arrest Registry to Enhance Survival data between 2013 and 2019 were linked to Medicare data using probabilistic matching algorithms. Overall long-term mortality, readmissions, and index hospitalization costs are reported for the overall cohort.

Results

Among 56 425 patients who were 65 years of age or older in Cardiac Arrest Registry to Enhance Survival who survived to hospital admission, 26 875 (47.6%) were successfully linked to Medicare files. Mean (+SD) cost of the index hospitalization was $23 262+$24 199 and the median cost was $14 636 (interquartile range, $9930-$30 033). Overall, 8676 (32.3%) survived to hospital discharge with 38.0% discharged home, 11.8% to hospice care, and the remaining 50.2% to other inpatient, skilled nursing care, or rehabilitation facilities. Mortality after discharge was initially high (27.0% at 3 months) and then increased gradually, with 1- and 3-year mortality of 37.1% and 50.1%, respectively. During the first year, 40.1% were readmitted at least once, with 19.7% readmitted on > 1 occasion.

Conclusions

The Cardiac Arrest Registry to Enhance Survival: Mortality, Events, and Costs for Cardiac Arrest survivors registry includes rich data on postdischarge outcomes and resource utilization. Use of this dataset will enable future investigations on the long-term effectiveness, costs, and cost-effectiveness of various interventions for out-of-hospital cardiac arrest in elderly patients.

SUBMITTER: Chan PS

PROVIDER: S-EPMC9694664 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Long-Term Outcomes for Out-of-Hospital Cardiac Arrest in Elderly Patients: An Analysis of Cardiac Arrest Registry to Enhance Survival Data Linked to Medicare Files.

Chan Paul S PS McNally Bryan B Chang Anping A Girotra Saket S Al-Araji Rabab R Mawani Minaz M Ahn Ki Ok KO Merritt Robert R

Circulation. Cardiovascular quality and outcomes 20221004 10

<h4>Background</h4>Most studies on out-of-hospital cardiac arrest have primarily focused on in-hospital or short-term survival. Little is known about long-term outcomes and resource use among survivors of out-of-hospital cardiac arrest.<h4>Methods</h4>In this observationsl study, we describe overall long-term outcomes for patients from the national Cardiac Arrest Registry to Enhance Survival linked to Medicare files to create the Cardiac Arrest Registry to Enhance Survival: Mortality, Events, an ...[more]

PMID: 36193751

Similar Datasets

Project description:IntroductionMobile applications, as innovative tools for promoting bystander cardiopulmonary resuscitation (CPR), have demonstrated potential to improve outcomes for patients experiencing out-of-hospital cardiac arrest (OHCA). This meta-analysis sought to systematically review the technical features of existing mobile applications and evaluate their impact on OHCA patient outcomes under various emergency response strategies. The findings aimed to guide the development and optimization of prehospital public emergency response systems.MethodsA systematic search was conducted in databases including China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Scientific Journals Database (VIP), SinoMed, PubMed, Embase, Web of Science, and the Cochrane Library, from inception to August 2023. The included studies involved notifying citizens via text messages or smartphone applications to act as first responders or volunteers in OHCA cases. Using a random effects model and subgroup analysis, we synthesized the results to identify sources of heterogeneity and assess outcomes.ResultsThirteen mobile applications were included, with an average activation rate of 35.3% among patients and a volunteer arrival rate of 53.3%. Compared to traditional emergency medical services, mobile applications significantly improved survival to discharge or 30-day survival rates (RR = 1.34, 95% CI: 1.24-1.44; P < 0.05), return of spontaneous circulation (ROSC) rates upon hospital admission (RR = 1.23, 95% CI: 1.09-1.40; P < 0.05), bystander CPR rates (RR = 1.25, 95% CI: 1.13-1.37; P < 0.05), and bystander defibrillation rates (RR = 1.23, 95% CI: 1.00-1.51; P = 0.05). Subgroup analyses revealed consistent results for bystander CPR rates and survival outcomes, while variations in defibrillation rates and ROSC at admission were observed, indicating potential influences of application design and operational parameters.ConclusionsThis study highlighted the significant potential of mobile applications in enhancing bystander interventions and improving patient outcomes. Addressing challenges such as improving access to automated external defibrillators and raising public awareness remained essential to maximizing their overall effectiveness. PROSPERO REGISTRATION NUMBER: CRD42023477676.

Project description:BackgroundTo enable older people to make decisions about the appropriateness of cardiopulmonary resuscitation (CPR), information is needed about the predictive value of pre-arrest factors such as comorbidity, functional and cognitive status on survival and quality of life of survivors. We systematically reviewed the literature to identify pre-arrest predictors for survival, quality of life and functional outcomes after out-of-hospital (OHC) CPR in the elderly.MethodsWe searched MEDLINE (through May 2011) and included studies that described adults aged 70 years and over needing CPR after OHC cardiac arrest. Prognostic factors associated with survival to discharge and quality of life of survivors were extracted. Two authors independently appraised the quality of each of the included studies. When possible a meta-analysis of odd's ratios was performed.ResultsTwenty-three studies were included (n = 44,582). There was substantial clinical and statistical heterogeneity and reporting was often inadequate. The pooled survival to discharge in patients >70 years was 4.1% (95% CI 3.0-5.6%). Several studies showed that increasing age was significantly associated with worse survival, but the predictive value of comorbidity was investigated in only one study. In another study, nursing home residency was independently associated with decreased chances of survival. Only a few small studies showed that age is negatively associated with a good quality of life of survivors. We were unable to perform a meta-analysis of possible predictors due to a wide variety in reporting and statistical methods.ConclusionsAlthough older patients have a lower chance of survival after CPR in univariate analysis (i.e. 4.1%), older age alone does not seem to be a good criterion for denying patients CPR. Evidence for the predictive value of comorbidities and for the predictive value of age on quality of life of survivors is scarce. Future studies should use uniform methods for reporting data and pre-arrest factors to increase the available evidence about pre arrest factors on the chance of survival. Furthermore, patient-specific outcomes such as quality of life and post-arrest cognitive function should be investigated too.

Dataset Information

Long-Term Outcomes for Out-of-Hospital Cardiac Arrest in Elderly Patients: An Analysis of Cardiac Arrest Registry to Enhance Survival Data Linked to Medicare Files.

Background

Methods

Results

Conclusions

Publications

Long-Term Outcomes for Out-of-Hospital Cardiac Arrest in Elderly Patients: An Analysis of Cardiac Arrest Registry to Enhance Survival Data Linked to Medicare Files.

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