Impact of transport time and cardiac arrest centers on the neurological outcome after out-of-hospital cardiac arrest: A retrospective cohort study

Cheng Yu Chien, Shang Li Tsai, Li Heng Tsai, Chen Bin Chen, Chen June Seak, Yi Ming Weng, Chi Chun Lin, Chip Jin Ng, Wei Che Chien, Chien Hsiung Huang, Cheng Yu Lin, Chung Hsien Chaou, Peng Huei Liu, Hsiao Jung Tseng, Chi Tai Fang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

24 Scopus citations

Abstract

BACKGROUND: Should all out-of-hospital cardiac arrest (OHCA) patients be directly transported to cardiac arrest centers (CACs) remains under debate. Our study evaluated the impacts of different transport time and destination hospital on the outcomes of OHCA patients. METHODS AND RESULTS: Data were collected from 6655 OHCA patients recorded in the regional prospective OHCA registry database of Taoyuan City, Taiwan, between January 2012 and December 2016. Patients were matched on propensity score, which left 5156 patients, 2578 each in the CAC and non-CAC groups. Transport time was dichotomized into <8 and ≥8 min-utes. The relations between the transport time to CACs and good neurological outcome at discharge and survival to discharge were investigated. Of the 5156 patients, 4215 (81.7%) presented with nonshockable rhythms and 941 (18.3%) presented with shockable rhythms. Regardless of transport time, transportation to a CAC increased the likelihoods of survival to discharge (<8 minutes: adjusted odds ratio [aOR], 1.95; 95% CI, 1.11–3.41; ≥8 minutes: aOR, 1.92; 95% CI, 1.25–2.94) and good neurological outcome at discharge (<8 minutes: aOR, 2.70; 95% CI, 1.40–5.22; ≥8 minutes: aOR, 2.20; 95% CI, 1.29–3.75) in OHCA patients with shockable rhythms but not in patients with nonshockable rhythms. CONCLUSIONS: OHCA patients with shockable rhythms transported to CACs demonstrated higher probabilities of survival to discharge and a good neurological outcome at discharge. Direct ambulance delivery to CACs should thus be considered, particularly when OHCA patients present with shockable rhythms.

Original languageEnglish
Article numbere015544
JournalJournal of the American Heart Association
Volume9
Issue number11
DOIs
StatePublished - 2020

Bibliographical note

Publisher Copyright:
© 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Keywords

  • Cardiac arrest center
  • Initial rhythm
  • Neurological outcome
  • Out-of-hospital cardiac arrest
  • Transport time

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