Pembroke Hill High School Kansas City MO.
Center for Healthcare Outcomes and Policy University of Michigan Ann Arbor MI.
J Am Heart Assoc. 2021 Feb;10(5):e017509. doi: 10.1161/JAHA.120.017509. Epub 2021 Feb 15.
Background Although many hospitals have resuscitation champions, it is unknown if hospitals with very active physician or nonphysician champions have higher survival rates for in-hospital cardiac arrest (IHCA). Methods and Results We surveyed adult hospitals in Get With The Guidelines-Resuscitation about resuscitation practices, including about their resuscitation champion. Hospitals were categorized as having a very active physician champion, a very active nonphysician champion, or other (no champion or not very active champion). For each hospital, we calculated risk-standardized survival rates for IHCA during the period of 2016 to 2018 and categorized them into quintiles of risk-standardized survival rates. The association between a hospital's resuscitation champion type and their quintile of survival was evaluated using multivariable hierarchical proportional odds logistic regression. Overall, 192 hospitals (total of 44 477 IHCAs) comprised the study cohort. Risk-standardized survival rates for IHCA varied widely between hospitals (median: 24.7%; range: 9.2%-37.5%). Very active physician champions were present in 29 (15.1%) hospitals, 64 (33.3%) had very active nonphysician champions, and 99 (51.6%) did not have a very active champion. Compared with sites without a very active resuscitation champion, hospitals with a very active physician champion were 4 times more likely to be in a higher survival quintile, even after adjusting for resuscitation practices across hospital groups (adjusted odds ratio [OR], 3.90; 95% CI, 1.39-10.95). In contrast, there was no difference in survival between sites without very active champions and those with very active non-physician champions (adjusted OR, 1.28; 95% CI, 0.62-2.65). Conclusions The background and engagement level of a resuscitation champion is a critical factor in a hospital's survival outcomes for IHCA.
尽管许多医院都有复苏冠军，但尚不清楚是否有非常活跃的医生或非医生冠军的医院，院内心搏骤停（IHCA）的生存率更高。
我们调查了 Get With The Guidelines-Resuscitation 中的成人医院的复苏实践，包括他们的复苏冠军。医院分为有非常活跃的医生冠军、非常活跃的非医生冠军或其他（无冠军或不是非常活跃的冠军）。对于每家医院，我们计算了 2016 年至 2018 年期间 IHCA 的风险标准化生存率，并将其分为风险标准化生存率五分位数。使用多变量分层比例优势逻辑回归评估医院复苏冠军类型与生存率五分位的关系。共有 192 家医院（共 44477 例 IHCA）组成了研究队列。IHCA 的风险标准化生存率在医院之间差异很大（中位数：24.7%；范围：9.2%-37.5%）。29 家（15.1%）医院有非常活跃的医生冠军，64 家（33.3%）有非常活跃的非医生冠军，99 家（51.6%）没有非常活跃的冠军。与没有非常活跃复苏冠军的医院相比，有非常活跃医生冠军的医院更有可能处于更高的生存率五分位数，即使在调整了医院组的复苏实践后也是如此（调整后的优势比[OR]，3.90；95%CI，1.39-10.95）。相比之下，没有非常活跃冠军的医院和有非常活跃非医生冠军的医院之间的生存率没有差异（调整后的 OR，1.28；95%CI，0.62-2.65）。
复苏冠军的背景和参与度是医院 IHCA 生存率的关键因素。
