Evidence map›Paper›PMID 32907387›Full record

ArticleCirculation. Cardiovascular quality and outcomes2020

Trajectory of Risk-Standardized Survival Rates for In-Hospital Cardiac Arrest.

Abdul H Qazi, Paul S Chan, Yunshu Zhou, Mary Vaughan-Sarrazin, Saket Girotra, American Heart Association Get With the Guidelines—Resuscitation Investigators

Abstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Cardiovascular quality and outcomes, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Abdul H QaziDivision of Cardiovascular Diseases, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City (A.H.Q., M.V.-S., S.G.).
Paul S ChanSaint Luke's Mid America Heart Institute and the University of Missouri, Kansas City (P.S.C.).
Yunshu ZhouDepartment of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor (Y.Z.).
Mary Vaughan-SarrazinDivision of Cardiovascular Diseases, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City (A.H.Q., M.V.-S., S.G.).
Saket GirotraDivision of Cardiovascular Diseases, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City (A.H.Q., M.V.-S., S.G.).
American Heart Association Get With the Guidelines—Resuscitation Investigators

Funding

Hospital Enhancement of Resuscitation Outcomes for In-Hospital Cardiac Arrest (HER01HL123980 · NHLBI · SAINT LUKE'S HOSPITAL · PI CHAN, PAUL SHEUNG-YAN, NALLAMOTHU, BRAHMAJEE K · 2014 to 2018
$2.7M
Post-Resuscitation Care and Survival After In-hospital Cardiac ArrestK08HL122527 · NHLBI · UNIVERSITY OF IOWA · PI GIROTRA, SAKET · 2014 to 2018
$731k
NHLBI NIH HHS K08 HL122527NHLBI NIH HHS R01 HL123980
6 · The paper itself

Abstract

backgroundA hospital's risk-standardized survival rate (RSSR) for in-hospital cardiac arrest has emerged as an important metric to benchmark and incentivize hospital resuscitation quality. We examined whether hospital performance on the RSSR metric was stable or dynamic year-over-year and whether low-performing hospitals were able to improve survival outcomes over time. METHODS AND

resultsWe used data from 84 089 adult patients with an in-hospital cardiac arrest from 166 hospitals with continuous participation in Get With The Guidelines-Resuscitation from 2012 to 2017. A 2-level hierarchical regression model was used to compute RSSRs during a baseline (2012-2013) and two follow-up periods (2014-2015 and 2016-2017). At baseline, hospitals were classified as top-, middle-, and bottom-performing if they ranked in the top 25%, middle 50%, and bottom 25%, respectively, on their RSSR metric during 2012 to 2013. We compared hospital performance on RSSR during follow-up between top, middle, and bottom-performing hospitals' at baseline. During 2012 to 2013, 42 hospitals were identified as top-performing (median RSSR, 31.7%), 82 as middle-performing (median RSSR, 24.6%), and 42 as bottom-performing (median RSSR, 18.7%). During both follow-up periods, >70% of top-performing hospitals ranked in the top 50%, a substantial proportion remained in the top 25% of RSSR during 2014 to 2015 (54.6%) and 2016 to 2017 (40.4%) follow-up periods. Likewise, nearly 75% of bottom-performing hospitals remained in the bottom 50% during both follow-up periods, with 50.0% in the bottom 25% of RSSR during 2014 to 2015 and 40.5% in the bottom 25% during 2016 to 2017. While percentile rankings were generally consistent over time at ≈45% of study hospitals, ≈1 in 5 (21.4%) bottom-performing hospitals showed large improvement in percentile rankings over time and a similar proportion (23.7%) of top-performing hospitals showed large decline in percentile rankings compared with baseline.

conclusionsHospital performance on RSSR during baseline period was generally consistent over 4 years of follow-up. However, 1 in 5 bottom-performing hospitals had large improvement in survival over time. Identifying care and quality improvement innovations at these sites may provide opportunities to improve in-hospital cardiac arrest care at other hospitals.

Indexed as

InpatientsQuality ImprovementQuality Indicators, Health CareResuscitationAgedAged, 80 and overFemaleHeart ArrestHospital MortalityHumansMaleMiddle AgedPrognosisRegistriesRisk AssessmentRisk Factorsbenchmarkinghospitalsquality improvementresuscitationsurvival rate

Identifiers

PMID32907387
PMCPMC7539545

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.