Faculty Collaboration Database

Cardiac arrest survival did not increase in the Resuscitation Outcomes Consortium after implementation of the 2005 AHA CPR and ECC guidelines. Resuscitation 2011 Aug;82(8):979-83

Date

04/19/2011

Pubmed ID

21497983

Pubmed Central ID

PMC3744665

DOI

10.1016/j.resuscitation.2011.03.024

Scopus ID

2-s2.0-79960230356 (requires institutional sign-in at Scopus site)   43 Citations

Abstract

INTRODUCTION: We examined the effect of the 2005 American Heart Association guidelines on survival in the Resuscitation Outcomes Consortium (ROC) Cardiac Arrest Epistry.

METHODS: We surveyed 174 EMS agencies from 8 of 10 ROC sites to determine 2005 AHA guideline implementation, or crossover, date. Two sites with 2005 compatible treatment algorithms prior to guideline release, and agencies that did not adopt the new guidelines during the study period were excluded. Non-traumatic adult cardiac arrests that were not witnessed by EMS, and did not have do not resuscitate orders were included. A linear mixed effects model was applied for survival controlling for time and agency. The "crossover" date was added to the model to determine the effect of the 2005 guidelines.

RESULTS: Of 174 agencies, 85 contributed cases to both cohorts during the 18 month period between 2005/12/01 and 2007/05/31. Of 7779 cases, 5054 occurred during the 13 month (median) interval before crossover and 2725 occurred in the five month (median) interval after crossover. The overall survival rate was 6.1%; 5.8% in the old cohort vs. 6.5%, p=0.23. For VF/VT patients, survival was 14.6% vs. 18.0%, p=0.063. Our model estimated no increase in survival over time (monthly OR 1.014, 95% CI 0.988, 1.041, p=0.28).

CONCLUSION: This study found no significant change in survival rate over time in the early months after implementation. Further longitudinal study is needed to determine the full impact of the guidelines on survival and methods to translate knowledge quickly and effectively in EMS.

Author List

Bigham BL, Koprowicz K, Rea T, Dorian P, Aufderheide TP, Davis DP, Powell J, Morrison LJ, ROC Investigators

Author

Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Algorithms
American Heart Association
Analysis of Variance
Cardiopulmonary Resuscitation
Diffusion of Innovation
Emergency Medical Services
Female
Guideline Adherence
Humans
Linear Models
Male
Middle Aged
Out-of-Hospital Cardiac Arrest
Practice Guidelines as Topic
Prospective Studies
Survival Rate
United States