Hospitals' cardiac arrest cases linked to survival rates


Hospitals with the highest rates of cardiac arrests tend to have the poorest survival rates for those cases, according to a study conducted by the University of Michigan Health System.

The study results, published in JAMA Internal Medicine, also indicate hospitals with exceptional rates of survival for in-hospital cardiac arrest are better at preventing cardiac arrests.

The study looked at hospitals across the country that had at least 50 adult in-hospital cardiac arrest cases between Jan. 1, 2000, and Nov. 30, 2009. The research team evaluated the correlation between the hospital's cardiac arrest incidence rates and its case survival rate after adjusting for patient and hospital characteristics. Of the 102,153 cases at 358 hospitals, the median hospital cardiac arrest incidence rate was 4.02 per 1,000 admissions and the median hospital case-survival rate was 18.8 percent.

The basic conclusion: Hospitals with higher case survival rates also had lower cardiac arrest cases.

"Our results should be reassuring to patients seeking to identify the best hospital in the area of cardiac arrest," lead author Lena M. Chen, M.D., M.S., assistant professor in internal medicine at the University of Michigan, said in a research announcement.  "Hospitals that had lower rates of cardiac arrest were more likely to have better outcomes for patients who did arrest."

Researchers say the results indicate national efforts to improve the quality of hospital care for cardiac arrest by measuring hospitals' cardiac arrest survival rates are an appropriate first step toward reducing mortality from the condition, according to the announcement.

Although researchers couldn't fully explain the correlation between a hospital's performance on prevention and treatment, their findings suggest more nurses per bed might be a factor, according to MedPage Today. When they adjusted for hospital characteristics, such as ownership, geographic region, type of hospital, and nurse-to-bed ratio, the negative correlation was noticeably decreased and no longer significant.

The largest shifts from negative to positive correlation were caused by adjustment for geographic region and nurse-to-bed ratio, Chen and colleagues write in the abstract.

"Our overarching goal is to reduce mortality from cardiac arrest--whether through better prevention or better treatment of cardiac arrest. A next step is to identify what's behind the success of hospitals that have already figured out how to be winners on both fronts --prevention and treatment," says Chen.

To learn more:
- read the study abstract
- check out the University of Michigan statement
- see the MedPage report