National Academies Press: OpenBook

Strategies to Improve Cardiac Arrest Survival: A Time to Act (2015)

Chapter: D-- Selected Results from Commissioned Analyses

« Previous: C-- Committee Biographies
Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×

D

Selected Results from Commissioned Analyses

The following maps and tables include selected results from the Committee’s commissioned analysis of data from Cardiac Arrest Registry to Enhance Survival (CARES), Resuscitation Outcomes Consortium (ROC) Epistry, and Get With The Guidelines-Resuscitation (GWTG-R) registry. The commissioned reports are available on the Institute of Medicine website.

TABLE D-1 2013 Incidence and Outcomes of Out-of-Hospital Cardiac Arrest

Cardiac Arrest Registry to Enhance Survival (CARES) Resuscitation Outcomes Consortium (ROC)
Incidence (%) Survival (%) Incidence (%) Survival* (%)
Total, EMS-treated arrests of presumed cardiac etiology 87.1 10.6 84.1 11.2
Patient characteristics
Mean patient age 62.8 62.1
Gender
   Male 60.8 11.8 60.6 12.5
   Female 39.2 9.6 39.4 9.2
Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×
Cardiac Arrest Registry to Enhance Survival (CARES) Resuscitation Outcomes Consortium (ROC)
Incidence (%) Survival (%) Incidence (%) Survival* (%)
Race
   White 46.2 11.5 51.9 12.6
   American-Indian/ 0.5 10.8
   Alaskan
   Asian 1.6 10.4
   Black/African- 18.8 9.3
   American
   Hispanic/Latino 6.2 11.9
   Native Hawaiian/ 0.7 7.1
   Pacific Islander
   Unknown 26.1 10.9 19.3 9.3
   Other 28.8
Income
   <$20,000 3.6 8.4
   $20,000-$29,999 11.0 8.9
   $30,000-$39,999 17.9 8.7
   $40,000-$49,999 18.4 8.6
   $50,000-$59,999 15.9 8.8
   $60,000-$69,999 11.8 8.7
   $70,000-$79,999 8.2 9.2
   $80,000-$89,999 5.3 8.5
   $90,000-$99,999 3.0 8.4
   >$100,000 5.0 10.7
Event characteristics Initial cardiac rhythm
   VF/VT/shockable rhythm 21.1 29.4 20.5 30.0
   Unknown/ unshockable rhythm 11.0 12.2 1.1 36.4
   Asystole 46.4 2.8 49.4 2.2
   PEA 21.5 9.7 24.1 9.8
Etiology of arrest
   Presumed cardiac 87.1 10.6 92.2
   Other causes 12.9 7.8
Location of arrest
   Home/residence 70.1 9.0 48.3
   nursing home/ALF 10.4 4.8 12.7
Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×
Cardiac Arrest Registry to Enhance Survival (CARES) Resuscitation Outcomes Consortium (ROC)
Incidence (%) Survival (%) Incidence (%) Survival* (%)
Witness status
   Unwitnessed 49.9 4.8 50.3 4.5
   Bystander witnessed 37.7 16.4 35.9
   911/EMS-responder witnessed 12.4 18.8 12.1
   Bystander or EMS-responder witnessed 17.5
EMS characteristics
   Bystander CPR provided 39.6 12.5 43.1
   Bystander AED applied 4.4 21.7 2.4
      Yes 15.2 20.0 4.1
      No 84.8 9.3 95.9
   Hypothermia provided (in hospital)
   Yes 50.1 36.6 41.6
   No 49.9 40.0
Additional information
Good neurologic status at discharge (CPC = 1; mRS ≤3)
      VT/VF 70.5 89.9
      PEA 45.8 81.8
      Asystole 42.8 73.6
   Cardiac catheterization performed 26.4

NOTES: ROC data on survival outcome was only available for the year 2011.
AED = automated external defibrillator; ALF = assisted living facility; CPC = cerebral performance category; CPR = cardiopulmonary resuscitation; mRS = Modified Rankin Score; PEA = pulseless electrical activity; VF = ventricular fibrillation; VT = ventricular tachycardia. The prepublication version of this report listed the PEA data point (under “additional information”) as 42.8 and the asystole data point as 45.8.
SOURCES: Based on data from the CARES and ROC registries. Daya et al., 2015; Vellano et al., 2015.

Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×

TABLE D-2 Incidence and Outcomes of In-Hospital Cardiac Arrest in 2013

Get With The Guidelines - Resuscitation
Patient Characteristics Incidence (%) Survival (%)
Mean age 65.1
Gender

Male

58.8 24.5

Female

41.2 24.4
Race

White

68.7 72.9

Black

23.5 20.0

Other

1.8 1.7

Unknown

6.0 5.4
Event Characteristics
Etiology of arrest

Medical-cardiac

37.2 40.2

Medical-noncardiac

45.9 36.6

Surgical-cardiac

6.6 11.3

Surgical-noncardiac

10.4 11.9
Location of arrest

ICU

48.8 39.7

Monitored unit

15.0 18.0

Non-monitored unit

14.4 12.9

ED

12.4 13.8
Initial cardiac rhythm

Asystole

28.0 23.1

PEA

54.6 44.3

VF

10.0 18.9

pVT

7.4 13.7
Other
Day and Time of Arrest

Daytime

49.3 27.5

Night time

16.6 20.7

Weekend

32.7 21.3
AED use (among non-ICU patients only)

Yes

34.0 27.7

No

66.0 29.5
Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×
Get With The Guidelines - Resuscitation
Patient Characteristics Incidence (%) Survival (%)
U.S. Region

North Mid-Atlantic

13.8 24.1

South Atlantic

20.7 23.4

North Central

15.2 27.9

South Central

17.8 22.9

Mountain Pacific

8.9 26.0
Is Hospital Rural or Urban?

Rural

2.6 24.4

Urban

74.0 24.6

NOTE: AED = automated external defibrillator; ED = emergency department; ICU = intensive care unit; PEA = pulseless electrical activity; pVT = pulseless ventricular tachycardia; VF = ventricular fibrillation; VT = ventricular tachycardia.
SOURCE: Based on data from the GWTG-R registry.

Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×

image

FIGURE D-1 Cardiac Arrest Registry to Enhance Survival (CARES) participatiing sites.
SOURCE: Vellano et al., 2015.

Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×

image

FIGURE D-2 Resuscitation Outcomes Consortium (ROC) participating sites.
SOURCE: Daya et al., 2015.

Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×

image

FIGURE D-3 Get With The Guidelines-Resuscitation registry.
NOTE: This map displays 317 hospitals. Data years: The American Heart Association hospital data from July 18, 2014; Dartmouth Atlas hospital service areas 2005; 2011 Environmental Systems Research Institute population estimates.
SOURCE: Reprinted with permission from Microsoft Dynamics.

Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×

REFERENCES

Chan, P. 2015. Public health burden of in hospital cardiac arrest. IOM Commissioned Report. http://www.iom.edu/~/media/Files/Report%20Files/2015/GWTG.pdf (accessed June 19, 2015).

Daya, M., R. Schmicker, S. May, and L. Morrison. 2015. Current burden of cardiac arrest in the United States: Report from the Resuscitation Outcomes Consortium. Paper commissioned by the Committee on the Treatment of Cardiac Arrest: Current Status and Future Directions. http://www.iom.edu/~/media/Files/Report%20Files/2015/ROC.pdf (accessed June 30, 2015).

Vellano, K., A. Crouch, M. Rajdev, and B. McNally. 2015. Cardiac Arrest Registry to Enhance Survival (CARES) report on the public health burden of out-of-hospital cardiac arrest. http://www.iom.edu/~/media/Files/Report%20Files/2015/CARES.pdf (accessed June 19, 2015).

Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×

This page intentionally left blank.

Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×
Page 423
Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×
Page 424
Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×
Page 425
Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×
Page 426
Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×
Page 427
Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×
Page 428
Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×
Page 429
Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×
Page 430
Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×
Page 431
Suggested Citation:"D-- Selected Results from Commissioned Analyses." Institute of Medicine. 2015. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: The National Academies Press. doi: 10.17226/21723.
×
Page 432
Next: E-- Map of U.S. States with CPR Training as a High School Graduation Requirement »
Strategies to Improve Cardiac Arrest Survival: A Time to Act Get This Book
×
Buy Paperback | $74.00 Buy Ebook | $59.99
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

Cardiac arrest can strike a seemingly healthy individual of any age, race, ethnicity, or gender at any time in any location, often without warning. Cardiac arrest is the third leading cause of death in the United States, following cancer and heart disease. Four out of five cardiac arrests occur in the home, and more than 90 percent of individuals with cardiac arrest die before reaching the hospital. First and foremost, cardiac arrest treatment is a community issue - local resources and personnel must provide appropriate, high-quality care to save the life of a community member. Time between onset of arrest and provision of care is fundamental, and shortening this time is one of the best ways to reduce the risk of death and disability from cardiac arrest. Specific actions can be implemented now to decrease this time, and recent advances in science could lead to new discoveries in the causes of, and treatments for, cardiac arrest. However, specific barriers must first be addressed.

Strategies to Improve Cardiac Arrest Survival examines the complete system of response to cardiac arrest in the United States and identifies opportunities within existing and new treatments, strategies, and research that promise to improve the survival and recovery of patients. The recommendations of Strategies to Improve Cardiac Arrest Survival provide high-priority actions to advance the field as a whole. This report will help citizens, government agencies, and private industry to improve health outcomes from sudden cardiac arrest across the United States.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    Switch between the Original Pages, where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

    « Back Next »
  6. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  7. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  8. ×

    View our suggested citation for this chapter.

    « Back Next »
  9. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!