Inter-hospital trends of post-resuscitation interventions and outcomes of out-of-hospital cardiac arrest in Singapore.
10.47102/annals-acadmedsg.2021498
- Author:
Julia Li Yan JAFFAR
1
;
Stephanie FOOK-CHONG
;
Nur SHAHIDAH
;
Andrew Fu Wah HO
;
Yih Yng NG
;
Shalini ARULANANDAM
;
Alexander WHITE
;
Le Xuan LIEW
;
Nurul ASYIKIN
;
Benjamin Sieu Hon LEONG
;
Han Nee GAN
;
Desmond MAO
;
Michael Yih Chong CHIA
;
Si Oon CHEAH
;
Marcus Eng Hock ONG
Author Information
1. Ministry of Health Holdings, Singapore.
- Collective Name:for Singapore PAROS investigators
- Publication Type:Journal Article
- MeSH:
Hospitals, Public;
Humans;
Out-of-Hospital Cardiac Arrest/therapy*;
Percutaneous Coronary Intervention;
Prospective Studies;
Singapore/epidemiology*
- From:Annals of the Academy of Medicine, Singapore
2022;51(6):341-350
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:Hospital-based resuscitation interventions, such as therapeutic temperature management (TTM), emergency percutaneous coronary intervention (PCI) and extracorporeal membrane oxygenation (ECMO) can improve outcomes in out-of-hospital cardiac arrest (OHCA). We investigated post-resuscitation interventions and hospital characteristics on OHCA outcomes across public hospitals in Singapore over a 9-year period.
METHODS:This was a prospective cohort study of all OHCA cases that presented to 6 hospitals in Singapore from 2010 to 2018. Data were extracted from the Pan-Asian Resuscitation Outcomes Study Clinical Research Network (PAROS CRN) registry. We excluded patients younger than 18 years or were dead on arrival at the emergency department. The outcomes were 30-day survival post-arrest, survival to admission, and neurological outcome.
RESULTS:The study analysed 17,735 cases. There was an increasing rate of provision of TTM, emergency PCI and ECMO (P<0.001) in hospitals, and a positive trend of survival outcomes (P<0.001). Relative to hospital F, hospitals B and C had lower provision rates of TTM (≤5.2%). ECMO rate was consistently <1% in all hospitals except hospital F. Hospitals A, B, C, E had <6.5% rates of provision of emergency PCI. Relative to hospital F, OHCA cases from hospitals A, B and C had lower odds of 30-day survival (adjusted odds ratio [aOR]<1; P<0.05 for hospitals A-C) and lower odds of good neurological outcomes (aOR<1; P<0.05 for hospitals A-C). OHCA cases from academic hospitals had higher odds ratio (OR) of 30-day survival (OR 1.3, 95% CI 1.1-1.5) than cases from hospitals without an academic status.
CONCLUSION:Post-resuscitation interventions for OHCA increased across all hospitals in Singapore from 2010 to 2018, correlating with survival rates. The academic status of hospitals was associated with improved survival.
