Survival factors of hospitalized out-of-hospital cardiac arrest patients in Taiwan: A retrospective study

Chung Yu Lai; Fu Huang Lin; Hsin Chu; Chih Hung Ku; Shih Hung Tsai; Chi Hsiang Chung; Wu Chien Chien; Chun Hsien Wu; Chi Ming Chu; Chi Wen Chang

doi:10.1371/journal.pone.0191954

Survival factors of hospitalized out-of-hospital cardiac arrest patients in Taiwan: A retrospective study

Chung Yu Lai
, Fu Huang Lin^*
, Hsin Chu
, Chih Hung Ku
, Shih Hung Tsai
, Chi Hsiang Chung
, Wu Chien Chien
, Chun Hsien Wu
, Chi Ming Chu
, Chi Wen Chang

^*此作品的通信作者

護理學系(含學碩博士班、碩士在職專班、學士後)

National Defense Medical University
Kainan University
Triservice General Hospital Taiwan
China Medical University Taichung
Fu Jen Catholic University
Chang Gung Memorial Hospital

研究成果: 期刊稿件 › 文章 › 同行評審

36 引文斯高帕斯（Scopus）

摘要

The chain of survival has been shown to improve the chances of survival for victims of cardiac arrest. Post-cardiac arrest care has been demonstrated to significantly impact the survival of out-of-hospital cardiac arrest (OHCA). How post-cardiac arrest care influences the survival of OHCA patients has been a main concern in recent years. The objective of this study was to assess the survival outcome of hospitalized OHCA patients and determine the factors associated with improved survival in terms of survival to discharge. We conducted a retrospective observational study by analyzing records from the National Health Insurance Research Database of Taiwan from 2007 to 2013. We collected cases with an International Classification of Disease Clinical Modification, 9^th revision primary diagnosis codes of 427.41 (ventricular fibrillation, VF) or 427.5 (cardiac arrest) and excluded patients less than 18 years old, as well as cases with an unknown outcome or a combination of traumatic comorbidities. We then calculated the proportion of survival to discharge among hospitalized OHCA patients. Factors associated with the dependent variable were examined by logistic regression. Statistical analysis was conducted using SPSS 22 (IBM, Armonk, NY). Of the 11,000 cases, 2,499 patients (22.7%) survived to hospital discharge. The mean age of subjects who survived to hospital discharge and those who did not was 66.7±16.7 and 71.7±15.2 years, respectively. After adjusting for covariates, neurological failure, cardiac comorbidities, hospital level, intensive care unit beds, transfer to another hospital, and length of hospital stay were independent predictors of improved survival. Cardiac rhythm on admission was a strong factor associated with survival to discharge (VF vs. non-VF: adjusted odds ratio: 3.51; 95% confidence interval: 3.06–4.01). In conclusion, cardiac comorbidities, hospital volume, cardiac rhythm on admission, transfer to another hospital and length of hospital stay had a significant positive association with survival to discharge in hospitalized OHCA patients in Taiwan.

原文	英語
文章編號	e0191954
期刊	PLoS ONE
卷	13
發行號	2
DOIs	https://doi.org/10.1371/journal.pone.0191954
出版狀態	已出版 - 02 2018

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Publisher Copyright:
© 2018 Lai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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10.1371/journal.pone.0191954

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title = "Survival factors of hospitalized out-of-hospital cardiac arrest patients in Taiwan: A retrospective study",

abstract = "The chain of survival has been shown to improve the chances of survival for victims of cardiac arrest. Post-cardiac arrest care has been demonstrated to significantly impact the survival of out-of-hospital cardiac arrest (OHCA). How post-cardiac arrest care influences the survival of OHCA patients has been a main concern in recent years. The objective of this study was to assess the survival outcome of hospitalized OHCA patients and determine the factors associated with improved survival in terms of survival to discharge. We conducted a retrospective observational study by analyzing records from the National Health Insurance Research Database of Taiwan from 2007 to 2013. We collected cases with an International Classification of Disease Clinical Modification, 9th revision primary diagnosis codes of 427.41 (ventricular fibrillation, VF) or 427.5 (cardiac arrest) and excluded patients less than 18 years old, as well as cases with an unknown outcome or a combination of traumatic comorbidities. We then calculated the proportion of survival to discharge among hospitalized OHCA patients. Factors associated with the dependent variable were examined by logistic regression. Statistical analysis was conducted using SPSS 22 (IBM, Armonk, NY). Of the 11,000 cases, 2,499 patients (22.7\%) survived to hospital discharge. The mean age of subjects who survived to hospital discharge and those who did not was 66.7±16.7 and 71.7±15.2 years, respectively. After adjusting for covariates, neurological failure, cardiac comorbidities, hospital level, intensive care unit beds, transfer to another hospital, and length of hospital stay were independent predictors of improved survival. Cardiac rhythm on admission was a strong factor associated with survival to discharge (VF vs. non-VF: adjusted odds ratio: 3.51; 95\% confidence interval: 3.06{\textendash}4.01). In conclusion, cardiac comorbidities, hospital volume, cardiac rhythm on admission, transfer to another hospital and length of hospital stay had a significant positive association with survival to discharge in hospitalized OHCA patients in Taiwan.",

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AU - Tsai, Shih Hung

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AU - Chien, Wu Chien

AU - Wu, Chun Hsien

AU - Chu, Chi Ming

AU - Chang, Chi Wen

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Survival factors of hospitalized out-of-hospital cardiac arrest patients in Taiwan: A retrospective study

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