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Multistate 5-Year Initiative to Improve Care for Out-of-Hospital Cardiac Arrest: Primary Results From the HeartRescue Project.

Publication ,  Journal Article
van Diepen, S; Girotra, S; Abella, BS; Becker, LB; Bobrow, BJ; Chan, PS; Fahrenbruch, C; Granger, CB; Jollis, JG; McNally, B; White, L ...
Published in: J Am Heart Assoc
September 22, 2017

BACKGROUND: The HeartRescue Project is a multistate public health initiative focused on establishing statewide out-of-hospital cardiac arrest (OHCA) systems of care to improve case capture and OHCA care in the community, by emergency medical services (EMS), and at hospital level. METHODS AND RESULTS: From 2011 to 2015 in the 5 original HeartRescue states, all adults with EMS-treated OHCA due to a presumed cardiac cause were included. In an adult population of 32.8 million, a total of 64 988 OHCAs-including 10 046 patients with a bystander-witnessed OHCA with a shockable rhythm-were treated by 330 EMS agencies. From 2011 to 2015, the case-capture rate for all-rhythm OHCA increased from an estimated 39.0% (n=6762) to 89.2% (n=16 103; P<0.001 for trend). Overall survival to hospital discharge was 11.4% for all rhythms and 34.0% in the subgroup with bystander-witnessed OHCA with a shockable rhythm. We observed modest temporal increases in bystander cardiopulmonary resuscitation (41.8-43.5%, P<0.001 for trend) and bystander automated external defibrillator application (3.2-5.6%, P<0.001 for trend) in the all-rhythm group, although there were no temporal changes in survival. There were marked all-rhythm survival differences across the 5 states (8.0-16.1%, P<0.001) and across participating EMS agencies (2.7-26.5%, P<0.001). CONCLUSIONS: In the initial 5 years, the HeartRescue Project developed a population-based OHCA registry and improved statewide case-capture rates and some processes of care, although there were no early temporal changes in survival. The observed survival variation across states and EMS systems presents a future challenge to elucidate the characteristics of high-performing systems with the goal of improving OHCA care and survival.

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

September 22, 2017

Volume

6

Issue

9

Location

England

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Registries
  • Quality Indicators, Health Care
  • Quality Improvement
  • Prospective Studies
  • Program Evaluation
  • Process Assessment, Health Care
  • Patient Discharge
 

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van Diepen, S., Girotra, S., Abella, B. S., Becker, L. B., Bobrow, B. J., Chan, P. S., … Rea, T. D. (2017). Multistate 5-Year Initiative to Improve Care for Out-of-Hospital Cardiac Arrest: Primary Results From the HeartRescue Project. J Am Heart Assoc, 6(9). https://doi.org/10.1161/JAHA.117.005716
Diepen, Sean van, Saket Girotra, Benjamin S. Abella, Lance B. Becker, Bentley J. Bobrow, Paul S. Chan, Carol Fahrenbruch, et al. “Multistate 5-Year Initiative to Improve Care for Out-of-Hospital Cardiac Arrest: Primary Results From the HeartRescue Project.J Am Heart Assoc 6, no. 9 (September 22, 2017). https://doi.org/10.1161/JAHA.117.005716.
van Diepen S, Girotra S, Abella BS, Becker LB, Bobrow BJ, Chan PS, et al. Multistate 5-Year Initiative to Improve Care for Out-of-Hospital Cardiac Arrest: Primary Results From the HeartRescue Project. J Am Heart Assoc. 2017 Sep 22;6(9).
van Diepen, Sean, et al. “Multistate 5-Year Initiative to Improve Care for Out-of-Hospital Cardiac Arrest: Primary Results From the HeartRescue Project.J Am Heart Assoc, vol. 6, no. 9, Sept. 2017. Pubmed, doi:10.1161/JAHA.117.005716.
van Diepen S, Girotra S, Abella BS, Becker LB, Bobrow BJ, Chan PS, Fahrenbruch C, Granger CB, Jollis JG, McNally B, White L, Yannopoulos D, Rea TD. Multistate 5-Year Initiative to Improve Care for Out-of-Hospital Cardiac Arrest: Primary Results From the HeartRescue Project. J Am Heart Assoc. 2017 Sep 22;6(9).
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

September 22, 2017

Volume

6

Issue

9

Location

England

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Registries
  • Quality Indicators, Health Care
  • Quality Improvement
  • Prospective Studies
  • Program Evaluation
  • Process Assessment, Health Care
  • Patient Discharge