Evidence map›Paper›PMID 36775019›Full record

ArticleResuscitation2023

Treatment and outcome variation in out-of-hospital cardiac arrest among four urban hospitals in Detroit.

Shobi Mathew, Nicholas Harrison, Sukhwindar Ajimal, Ryan Silvagi, Ryan Reece, Howard Klausner, Phillip Levy, Robert Dunne, Brian O'Neil

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Resuscitation, 2023. 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. Article
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

9 authors.

Shobi MathewDepartment of Emergency Medicine and Integrative Biosciences Center, Wayne State University, Detroit, MI 48201, United States.
Nicholas HarrisonDepartment of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States.
Sukhwindar AjimalDepartment of Emergency Medicine and Integrative Biosciences Center, Wayne State University, Detroit, MI 48201, United States.
Ryan SilvagiDepartment of Emergency Medicine and Integrative Biosciences Center, Wayne State University, Detroit, MI 48201, United States.
Ryan ReeceDepartment of Emergency Medicine and Integrative Biosciences Center, Wayne State University, Detroit, MI 48201, United States.
Howard KlausnerDepartment of Emergency Medicine, Henry Ford Hospital, Detroit, MI 48202, United States.
Phillip LevyDepartment of Emergency Medicine and Integrative Biosciences Center, Wayne State University, Detroit, MI 48201, United States.
Robert DunneDepartment of Emergency Medicine and Integrative Biosciences Center, Wayne State University, Detroit, MI 48201, United States.
Brian O'NeilDepartment of Emergency Medicine and Integrative Biosciences Center, Wayne State University, Detroit, MI 48201, United States. Electronic address: boneil@med.wayne.edu.

Funding

Quality Assurance and Quality Control Project Management: Improving Submissions and Study Conduct in the Human Subjects Research Prior Approval ProcessUL1TR002529 · NCATS · INDIANA UNIVERSITY INDIANAPOLIS · PI MOE, SHARON M, WIEHE, SARAH ELIZABETH · 2018 to 2022
$27.2M
Translating Measures of Visual Experience to Children with Autism and Down SyndromeKL2TR002530 · NCATS · INDIANA UNIVERSITY INDIANAPOLIS · PI ROBB, SHERI L · 2018 to 2022
$4.8M
NCATS NIH HHS KL2 TR002530NCATS NIH HHS UL1 TR002529
6 · The paper itself

Abstract

aimsTo determine whether out-of-hospital cardiac arrest (OHCA) post-resuscitation management and outcomes differ between four Detroit hospitals.

introductionSignificant variation exists in treatment/outcomes from OHCA. Disparities between hospitals serving a similar population is not well known.

methodsRetrospective OHCA data was collected from the Detroit-Cardiac Arrest Registry (DCAR) between January 2014 to December 2019. Four hospitals were compared on two treatments (angiography, do not resuscitate (DNR)) and two outcomes (cerebral performance category (CPC) ≤ 2, in-hospital death). Models for death and CPC were tested with and without coronary angiography and DNR status.

results999 patients at hospitals A - D differed (p < 0.05) before multivariable adjustment by age, race, witnessed arrest, dispatch-emergency department (ED) time, TTM, coronary angiography, DNR order, and in-hospital death. Rates of death and CPC ≤ 2 were worse in Hospital A (82.8%, 10%, respectively) compared to others (69.1%, 14.1%). After multivariable adjustment, Hospital A performed angiography less compared to B (OR = 0.17) and was more likely to initiate new DNR status than B (OR = 2.9), C (OR = 16.1), or D (OR = 3.6). CPC ≤ 2 were worse in Hospital A compared to B (OR = 0.27) and D (OR = 0.35). After sensitivity analysis, CPC ≤ 2 odds did not differ for A versus B (OR = 0.58, adjusted for angiography) or D (OR = 0.65, adjusted for DNR). Odds of death, despite angiography and DNR differences, were worse in Hospital A compared to B (OR = 1.87) and D (OR = 1.81).

conclusionDiffering rates of DNR and coronary angiography was associated with observed disparities in favorable neurologic outcome, but not death, between four Detroit hospitals.

Indexed as

Cardiopulmonary ResuscitationOut-of-Hospital Cardiac ArrestHospital MortalityHospitals, UrbanHumansRetrospective StudiesTreatment OutcomeCardiac arrestChain of survivalCoronary angiographyCPC, post-arrest careDo not resuscitateEmergency medical servicesOut-of-hospital cardiac arrestSurvival variationTargeted temperature management

Identifiers

PMID36775019
PMCPMC10696655

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Registered trials

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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.