Abstract
Aims
Patients suffering from out-of-hospital cardiac arrest (OHCA) are frequently transported
to the closest hospital. Percutaneous coronary intervention (PCI) is often indicated
following OHCA. This study’s primary objective was to determine the association between
being transported to a PCI-capable hospital and survival to discharge for patients
with OHCA. The additional delay to hospital arrival which could offset a potential
increase in survival associated with being transported to a PCI-capable center was
also evaluated.
Methods
This study used a registry of OHCA in Montreal, Canada. Adult patients transported
to a hospital following a non-traumatic OHCA were included. Hospitals were dichotomized
based on whether PCI was available on-site or not. The effect of hospital type on
survival to discharge was assessed using a multivariable logistic regression. The
added prehospital delay which could offset the increase in survival associated with
being transported to a PCI-capable center was calculated using that regression.
Results
A total of 4922 patients were included, of whom 2389 (48%) were transported to a PCI-capable
hospital and 2533 (52%) to a non-PCI-capable hospital. There was an association between
being transported to a PCI-capable center and survival to discharge (adjusted odds
ratio = 1.60 [95% confidence interval 1.25–2.05], p < .001). Increasing the delay
from call to hospital arrival by 14.0 min would offset the potential benefit of being
transported to a PCI-capable center.
Conclusions
It could be advantageous to redirect patients suffering from OHCA patients to PCI-capable
centers if the resulting expected delay is of less than 14 min.
Keywords
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Article info
Publication history
Published online: February 01, 2018
Accepted:
January 29,
2018
Received in revised form:
January 11,
2018
Received:
October 16,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
