Study indicates cardiac arrest treatment and survival varies widely in U.S. hospitals

February 24, 2016 – Top quality cardiac arrest care could save more than 22,000 lives each year, according to a new study by DCRI researchers.

A new study estimates that 22,990–24,200 lives could be saved each year if all U.S. hospitals had similar in-hospital cardiac arrest (IHCA) quality of care to that in place at the best institutions.

The study – by researchers from Duke and other American Heart Association’s Get With the Guidelines-Resuscitation investigators – is believed to be the first to examine variation between IHCA quality of care and outcomes using a hospital process composite performance measure. The composite measure is based on five guideline-recommended process-of-care measures. The study found significant variation in process quality of care achievement and survival rates for patients with IHCA treated at U.S. hospitals. The relationship between process quality of care measures and outcomes was evident after adjusting for both patient and hospital characteristics.

monique-anderson-news“We found that for every 10 percent increase in hospital composite performance, there was a 22 percent higher chance of survival, showing the need to improve adherence to guideline-recommended care overall, as well as to individual process of care measures,” said lead author and Duke cardiologist, Monique L. Anderson, MD, MHS, assistant professor of medicine and member of the DCRI (pictured). “Studies like this are important to drive the national conversation around public reporting and performance measures for cardiac arrest, adding new information on quality of care.”

The study, published today in the first issue of JAMA Cardiology, is entitled, “Association Between Hospital Process Composite Performance and Patient Outcomes.” The authors used the Get With The Guidelines-Resuscitation registry to analyze data on 35,283 IHCA patients treated at 261 U.S. hospitals (2010–2012).

More than 200,000 patients are treated each year for IHCA. Survival rates are generally low, but vary widely among U.S. centers. Previously, it was unclear whether this variability is due to IHCA process quality of care, or how IHCA process quality of care might affect patient outcomes. Recently, the Joint Commission, National Quality Forum, and the American Heart Association have all expressed an interest in developing performance measures specific to IHCA in hopes of facilitating benchmarking, with the ultimate goal of improving patient outcomes.

In addition to Anderson, study authors include: Graham Nichol; David Dai; Paul S. Chan; Laine Thomas; Sana M. Al-Khatib; Robert A. Berg; Steven M. Bradley; and Eric D. Peterson; for the American Heart Association’s Get With the Guidelines-Resuscitation Investigators.