| Autor: |
Vittal Hejjaji, MD, Apurba K. Chakrabarti, MD, Brahmajee K. Nallamothu, MD, MPH, Theodore J. Iwashyna, MD, PhD, Sarah L. Krein, PhD, RN, Brad Trumpower, MS, Marci Kennedy, BA, Khaja Chinnakondepalli, MS, Ali O. Malik, MD, Paul S. Chan, MD, MSc |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Předmět: |
|
| Zdroj: |
Mayo Clinic Proceedings: Innovations, Quality & Outcomes, Vol 5, Iss 6, Pp 1021-1028 (2021) |
| Druh dokumentu: |
article |
| ISSN: |
2542-4548 |
| DOI: |
10.1016/j.mayocpiqo.2021.06.002 |
| Popis: |
Objective: To assess whether survival rates for in-hospital cardiac arrest (IHCA) vary across hospitals depending on whether resuscitations are typically led by an attending physician, a physician trainee, or a nonphysician. Patients and Methods: In 2018, we conducted a survey of hospitals participating in the national Get with the Guidelines – Resuscitation registry for IHCA. Using responses from the question “Who typically leads codes at your institution?” we categorized hospitals on the basis of who typically leads their resuscitations: attending physician, physician trainee, or nonphysician. We then compared risk-adjusted hospital rates of return of spontaneous circulation, survival to discharge, and favorable neurological survival from 2015 to 2017 between these 3 hospital groups by using multivariable hierarchical regression. Results: Overall, 193 hospitals completed the study survey, representing a total of 44,477 IHCAs (mean age, 65.0±15.5 years; 40.8% were women). Most hospitals had resuscitations led by physicians, with 121 (62.7%) led by an attending physician, 58 (30.0%) by a physician trainee, and 14 (7.3%) by a nonphysician. The risk-standardized rates of survival to discharge were similar across hospitals, regardless of whether resuscitations were typically led by an attending physician, a physician trainee, or a nonphysician (25.6%±4.8%, 25.9%±4.7%, and 25.7%±3.6%, respectively; P=.88). Similarly, there were no differences between the 3 groups in risk-adjusted rates of return of spontaneous circulation (71.7%±6.3%, 73%±6.3%, and 73.4%±6.4%; P=.30) and favorable neurological survival (21.6%±7.1%, 22.7%±6.1%, and 20.9%±6.5%; P=.50). Conclusion: In hospitals in a national IHCA registry, IHCA resuscitations were usually led by physicians. However, there was no association between a hospital’s typical resuscitation team leader credentials and IHCA survival outcomes. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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