In-hospital cardiac arrest outcomes, incidence linked

Hospitals with higher rates of survival among patients who experience in-hospital cardiac arrest also appear to have a lower incidence of in-hospital cardiac arrest, according to a study.

Lena M. Chen, MD, MS, of the University of Michigan, Ann Arbor, and colleagues identified 102,153 cases of in-hospital cardiac arrest at 358 hospitals between January 2000 and November 2009.

The median hospital cardiac arrest incidence rate was 4.02 per 1,000 admissions, and the median hospital case-survival rate was 18.8%. In crude statistical analysis, hospitals with higher case-survival rates also had lower cardiac arrest incidence, according to the results.

The statistical relationship was lessened depending on several hospital characteristics, most notably the ratio of staff nurses to hospital beds. In other words, hospitals with a relatively high number of nurses per bed could have a better-than-average in-hospital cardiac arrest survival rate despite a higher-than-average number of cases.

“Hospitals that excelled at preventing cardiac arrests also had higher survival rates for cardiac arrest cases, and this correlation persisted after adjustment for patient case mix,” the authors wrote.

“We found evidence that certain hospital factors, in part, mediated this relationship, but only one of the factors we examined — a hospital’s nurse-to-bed ratio — is potentially quickly modifiable.”