Direct Transport to PCI-capable Hospitals After Out-of-hospital Cardiac Arrest in New Zealand: Inequities and Outcomes

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aut.relation.journalResuscitationen_NZ
aut.researcherOliver, Verity
dc.contributor.authorDicker, Ben_NZ
dc.contributor.authorTodd, VFen_NZ
dc.contributor.authorTunnage, Ben_NZ
dc.contributor.authorSwain, Aen_NZ
dc.contributor.authorSmith, Ten_NZ
dc.contributor.authorHowie, Gen_NZ
dc.date.accessioned2019-08-05T00:08:07Z
dc.date.available2019-08-05T00:08:07Z
dc.date.copyright2019en_NZ
dc.date.issued2019en_NZ
dc.description.abstractBACKGROUND: It is widely accepted that survival from OHCA may be improved through direct transfer of patients to hospitals with percutaneous coronary intervention (PCI) capability. However, within the New Zealand healthcare system there is limited evidence available to support this. We aimed to compare patient characteristics and outcomes following an out-of-hospital cardiac arrest between those patients transported to hospitals with or without PCI-capability within New Zealand. METHOD: A retrospective cohort study was conducted using data from the St John New Zealand OHCA registry for adults treated for an out-of-hospital cardiac arrest of presumed cardiac aetiology between 1 October 2013 and 31 October 2018. Population characteristics were investigated using a Chi-Square analysis. Binary logistic regression modelling was used to investigate outcome differences in survival at 30 days post-event according to receiving hospital PCI-capability. RESULTS: The study included 1750 patients who were transported to hospital following an OHCA. A significantly lower proportion of patients over 65 years (49.9%) were conveyed to hospitals with PCI-capability compared to younger aged patients (15-44 years (52.1%) and 45-64 years (59.7%) (p < 0.001). When ethnic groups were compared, Māori (32.9%) had the lowest proportion transported to PCI-capable hospitals, followed by European (55.6%) then Pacific Peoples (86.2%) (p < 0.001). A lower proportion of patients located rurally (34.7%) were transported to hospitals with PCI-capability compared to patients in an urban location (59.1%) (p < 0.001). Thirty-day survival was higher in patients transported to hospitals with PCI-capability (adjusted OR 1.285, 95%CI (1.01-1.63), p = 0.04). CONCLUSIONS: Patient characteristic differences indicate that inequities in healthcare may exist in New Zealand related to age, ethnic group, and rurality. Thirty-day survival was significantly increased in patients conveyed directly to a hospital with PCI-capability.en_NZ
dc.identifier.doi10.1016/j.resuscitation.2019.06.283en_NZ
dc.identifier.issn0300-9572en_NZ
dc.identifier.issn1873-1570en_NZ
dc.identifier.urihttps://hdl.handle.net/10292/12718
dc.languageengen_NZ
dc.publisherElsevieren_NZ
dc.relation.urihttps://www.sciencedirect.com/science/article/pii/S0300957219304988?via%3Dihub
dc.rightsUnder a Creative Commons license
dc.rights.accessrightsOpenAccessen_NZ
dc.subjectAmbulanceen_NZ
dc.subjectBy-passen_NZ
dc.subjectCardiac arresten_NZ
dc.subjectEMSen_NZ
dc.subjectEmergency medical serviceen_NZ
dc.subjectOHCAen_NZ
dc.subjectOut-of-hospitalen_NZ
dc.subjectPCIen_NZ
dc.subjectParamedicen_NZ
dc.subjectPercutaneous coronary interventionen_NZ
dc.titleDirect Transport to PCI-capable Hospitals After Out-of-hospital Cardiac Arrest in New Zealand: Inequities and Outcomesen_NZ
dc.typeJournal Article
pubs.elements-id361152
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Health & Environmental Science
pubs.organisational-data/AUT/Health & Environmental Science/Clinical Sciences
pubs.organisational-data/AUT/PBRF
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences/HH Clinical Sciences 2018 PBRF
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