Variations in cardiac arrest incidence points toward key factors

Survival rates for in-hospital cardiac arrests (IHCA) have plateaued at 25% in recent years. With nearly 290,000 people affected by IHCA each year, researchers aim to identify whether incidence of IHCA varies across hospitals in the United States, a key first step towards identifying best practices.

Tyler Rasmussen, MD, PhD, Internal Medicine Chief Fellow in Cardiology, and a team of researchers, including Saket Girotra, MD, associate professor in Cardiovascular Medicine, and Mary Vaughan-Sarrazin, PhD, associate professor in General Internal Medicine, analyzed IHCA data to identify potential prevention opportunities. Their findings were recently published in the Journal of the American Medical Association (JAMA) Network Open.

“Recent research has focused on improving IHCA survival. Efforts targeted towards prevention of IHCA could be impactful,” Rasmussen said. “We examined variation of IHCA incidence across US hospitals, which could help identify hospital practices targeted towards IHCA prevention.”

After analyzing data from 170 US hospitals and 38,630 patients, the team found a large variation in incidence of IHCA across the country. Among many hospital factors, the study revealed that a higher level of nurse staffing was associated with lower incidence of IHCA. On average, the data reported approximately 8 in every 1,000 hospital patients would experience IHCA. However, the variation IHCA incidence ranged from 2.4 to 25.5 per 1,000 admissions.

“The large variation in IHCA incidence across hospitals suggests that some hospitals have likely developed innovative approaches to identify and rescue patients before they progress to a cardiac arrest,” Girotra said. “Findings from this important study led by Dr. Rasmussen further support that an in-depth assessment of hospitals with exceptionally low IHCA incidence will be crucial for identifying best practices for preventing IHCA.”

In addition to Rasmussen, Vaughan-Sarrazin, and Girotra, contributions were also made by Danielle Riley, PhD candidate in the UI’s Department of Epidemiology, College of Public Health; and Paul Chan, MD, cardiologist at Saint Luke’s Hospital in Kansas City, Missouri.

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