Regional Variation in Outcomes of Hospitalized Patients Having Out-of-Hospital Cardiac Arrest

Aiham Albaeni, May A. Beydoun, Hind A. Beydoun, Bolanle Akinyele, Lekshminarayan RaghavaKurup, Nisha Chandra, Shaker M Eid

Research output: Contribution to journalArticle

Abstract

The aim of this study was to investigate patient outcomes after hospitalization for out-of-hospital cardiac arrest in the United States. We used the 2002 to 2013 Nationwide Inpatient Sample database to identify adults ≥18 years with an International Classification of Diseases, Ninth Revision, Clinical Modification, principal diagnosis code of cardiorespiratory arrest (427.5) or ventricular fibrillation (VF) (427.41). In 4 predefined federal geographic regions: Northeast, Midwest, South, and West, means and proportions of survival, survival stratified by initial rhythm, hospital charges, and cost were estimated. Multiple linear and logistic regression models were conducted. Of the 154,177 patients with out-of-hospital cardiac arrest hospitalized in the United States, 25,873 (16.8%) were in the Northeast, 38,296 (24.8%) in the Midwest, 57,305 (37.2%) in the South, and 32,703 (21.2%) in the West. Variability in survival was noted in VF arrests; compared with the Northeast, survival was higher in the Midwest and South (adjusted odds ratio [AOR] 1.16, 95% confidence interval [CI] 1.02 to 1.32 and AOR 1.24, 95% CI 1.09 to 1.40, respectively), with no difference detected in the West (AOR 0.93, 95% CI 0.82 to 1.06). No variability in survival was noted after non-VF arrests (p >0.05). Hospital charges rose significantly across all regions of the United States (p-trend < 0.001) and were higher in the West compared with the Northeast (hospital charges >$109,000/admission, AOR 1.76; 95% CI 1.50 to 2.06). In conclusion, nationwide, we observed significant regional variability in survival of hospitalized patients after out of hospital VF cardiac arrest, no survival variability after non-VF arrests, and a steady increase in hospital charges.

Original languageEnglish (US)
Pages (from-to)421-427
Number of pages7
JournalAmerican Journal of Cardiology
Volume120
Issue number3
DOIs
StatePublished - Aug 1 2017

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Out-of-Hospital Cardiac Arrest
Survival
Hospital Charges
Ventricular Fibrillation
Odds Ratio
Confidence Intervals
Logistic Models
Hospital Costs
International Classification of Diseases
Heart Arrest
Inpatients
Linear Models
Hospitalization
Databases

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Regional Variation in Outcomes of Hospitalized Patients Having Out-of-Hospital Cardiac Arrest. / Albaeni, Aiham; Beydoun, May A.; Beydoun, Hind A.; Akinyele, Bolanle; RaghavaKurup, Lekshminarayan; Chandra, Nisha; Eid, Shaker M.

In: American Journal of Cardiology, Vol. 120, No. 3, 01.08.2017, p. 421-427.

Research output: Contribution to journalArticle

Albaeni, Aiham ; Beydoun, May A. ; Beydoun, Hind A. ; Akinyele, Bolanle ; RaghavaKurup, Lekshminarayan ; Chandra, Nisha ; Eid, Shaker M. / Regional Variation in Outcomes of Hospitalized Patients Having Out-of-Hospital Cardiac Arrest. In: American Journal of Cardiology. 2017 ; Vol. 120, No. 3. pp. 421-427.
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abstract = "The aim of this study was to investigate patient outcomes after hospitalization for out-of-hospital cardiac arrest in the United States. We used the 2002 to 2013 Nationwide Inpatient Sample database to identify adults ≥18 years with an International Classification of Diseases, Ninth Revision, Clinical Modification, principal diagnosis code of cardiorespiratory arrest (427.5) or ventricular fibrillation (VF) (427.41). In 4 predefined federal geographic regions: Northeast, Midwest, South, and West, means and proportions of survival, survival stratified by initial rhythm, hospital charges, and cost were estimated. Multiple linear and logistic regression models were conducted. Of the 154,177 patients with out-of-hospital cardiac arrest hospitalized in the United States, 25,873 (16.8{\%}) were in the Northeast, 38,296 (24.8{\%}) in the Midwest, 57,305 (37.2{\%}) in the South, and 32,703 (21.2{\%}) in the West. Variability in survival was noted in VF arrests; compared with the Northeast, survival was higher in the Midwest and South (adjusted odds ratio [AOR] 1.16, 95{\%} confidence interval [CI] 1.02 to 1.32 and AOR 1.24, 95{\%} CI 1.09 to 1.40, respectively), with no difference detected in the West (AOR 0.93, 95{\%} CI 0.82 to 1.06). No variability in survival was noted after non-VF arrests (p >0.05). Hospital charges rose significantly across all regions of the United States (p-trend < 0.001) and were higher in the West compared with the Northeast (hospital charges >$109,000/admission, AOR 1.76; 95{\%} CI 1.50 to 2.06). In conclusion, nationwide, we observed significant regional variability in survival of hospitalized patients after out of hospital VF cardiac arrest, no survival variability after non-VF arrests, and a steady increase in hospital charges.",
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