Effect of intensive care after cardiac arrest on patient outcome: a database analysis (Epidemiologic Perspectives & Innovations)

IntroductionThe study aimed to determine the impact of treatment frequency, hospital size and capability on mortality of patients admitted after cardiac arrest for postresuscitation care to different intensive care units. Methods: Prospectively recorded data from 242588 adults consecutively admitted to 87 Austrian intensive care units over a period of 13 years (1998 to 2010) were analyzed retrospectively. Multivariate analysis was used to assess the effect of the frequency of postresuscitation care on mortality, correcting for baseline parameters, severity of illness, hospital size and capability to perform coronary angiography and intervention. Results: In total 5857 patients had suffered cardiac arrest and were admitted to an intensive care unit. Observed hospital mortality was 56% in the cardiac arrest cohort (3302 non survivors). Patients treated in intensive care units with a high frequency of postresuscitation care generally had high severity of illness (median Simplified Acute Physiology Score (SAPS II) 65). Intensive care units with a higher frequency of care showed improved risk adjusted mortality. The SAPS II adjusted, observed to expected mortality ratios (O/E-Ratios) in the three strata (less than