Association Between Direct Transport to a Cardiac Arrest Centre and Survival Following Out-of-Hospital Cardiac Arrest: A Propensity-Matched Aotearoa New Zealand Study

aut.relation.articlenumber100625
aut.relation.journalResuscitation Plus
aut.relation.startpage100625
aut.relation.volume18
dc.contributor.authorDicker, B
dc.contributor.authorGarrett, N
dc.contributor.authorHowie, G
dc.contributor.authorBrett, A
dc.contributor.authorScott, T
dc.contributor.authorStewart, R
dc.contributor.authorPerkins, GD
dc.contributor.authorSmith, T
dc.contributor.authorGarcia, E
dc.contributor.authorTodd, VF
dc.date.accessioned2024-04-23T03:39:41Z
dc.date.available2024-04-23T03:39:41Z
dc.date.issued2024-04-06
dc.description.abstractBackground and Objectives: Direct transport to a cardiac arrest centre following out-of-hospital cardiac arrest may be associated with higher survival. However, there is limited evidence available to support this within the New Zealand context. This study used a propensity score-matched cohort to investigate whether direct transport to a cardiac arrest centre improved survival in New Zealand. Methods: A retrospective cohort study was conducted using the Aotearoa New Zealand Paramedic Care Collection (ANZPaCC) database for adults treated for out-of-hospital cardiac arrest of presumed cardiac aetiology between 1 July 2018 to 30 June 2023. Propensity score-matched analysis was used to investigate survival at 30-days post-event according to the receiving hospital being a cardiac arrest centre versus a non-cardiac arrest centre. Results: There were 2,297 OHCA patients included. Propensity matching resulted in 554 matched pairs (n = 1108). Thirty-day survival in propensity score-matched patients transported directly to a cardiac arrest centre (56%) versus a non-cardiac arrest centre (45%) was not significantly different (adjusted Odds Ratio 0.78 95%CI 0.54, 1.13, p = 0.19). Shockable presenting rhythm, bystander CPR, and presence of STEMI were associated with a higher odds of 30 day survival (p < 0.05). Māori or Pacific Peoples ethnicity and older age were associated with lower survival (p < 0.05). Conclusions: This study found no statistically significant difference in outcomes for OHCA patients transferred to a cardiac arrest compared to a non-cardiac arrest centre. However, the odds ratio of 0.78, equivalent to a 22% decrease in 30-day mortality, is consistent with benefit associated with management by a cardiac arrest centre. Further research in larger cohorts with detailed information on known outcome predictors, or large randomised clinical trials are needed.
dc.identifier.citationResuscitation Plus, ISSN: 2666-5204 (Print); 2666-5204 (Online), Elsevier, 18, 100625-. doi: 10.1016/j.resplu.2024.100625
dc.identifier.doi10.1016/j.resplu.2024.100625
dc.identifier.issn2666-5204
dc.identifier.issn2666-5204
dc.identifier.urihttp://hdl.handle.net/10292/17456
dc.languageeng
dc.publisherElsevier
dc.relation.urihttps://www.sciencedirect.com/science/article/pii/S2666520424000766
dc.rights2024 The Authors. Published by Elsevier B.V.
dc.rights.accessrightsOpenAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectAotearoa
dc.subjectCardiac arrest
dc.subjectCardiac arrest centre
dc.subjectEMS
dc.subjectNew Zealand
dc.subjectOut of hospital
dc.subjectParamedic
dc.subjectResuscitation
dc.subject32 Biomedical and Clinical Sciences
dc.subject3202 Clinical Sciences
dc.subjectCardiovascular
dc.subjectHeart Disease
dc.subjectCardiovascular
dc.subject3 Good Health and Well Being
dc.subject3201 Cardiovascular medicine and haematology
dc.titleAssociation Between Direct Transport to a Cardiac Arrest Centre and Survival Following Out-of-Hospital Cardiac Arrest: A Propensity-Matched Aotearoa New Zealand Study
dc.typeJournal Article
pubs.elements-id544897
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