Effect of transported hospital resources on neurologic outcome after out-of-hospital cardiac arrest

Objective. Appropriate regional transport protocol for out-of-hospital cardiac arrest (OHCA) patients is important for achiev-ing favorable outcomes in a certain com-munity. This study aimed to investigate the effect of transported hospital resources on the neurologic outcome after OHCA. Methods. We categorized cardiac receiv-ing centers (CRC) in our community into two levels (primary [P-CRC] and definite CRC [D-CRC]) according to the hospital resources that were identified by the Hos-pital Assessment Survey in 2015. OHCA patients with presumed cardiac etiology resuscitated by emergency medical service providers between 2012 and 2014, were enrolled in the study. The main exposure was the level of CRC. The primary end-point was discharge with good neurologic outcomes. We compared outcomes be-tween CRCs after adjusting for potential confounders. 

Results. Among the 9,912 patients, 5,876 were transported to P-CRC and 4,036 to D-CRC from 2012 to 2014. Patients admit-ted to D-CRC showed better neurologic outcome than those admitted to P-CRC (6.2% vs 1.5%, p<0.001). With regard to patients who survived to admission, the neurologic outcome of patients in D-CRC was better than those in P-CRC (11.3% vs 3.3%, p<0.001). In the multivariable logis-tic model, the adjusted odds ratio for all OHCA patients was 2.10 (95% confidence interval, 1.51–2.95).Conclusion. Transportation of OHCA pa-tients to the D-CRC resulted in significant-ly good neurologic outcome than those transported to P-CRC. Further research is needed to establish a regional OHCA transport protocol.

cardiac arrest, outcome, region-alization 

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