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Title: Cardiopulmonary arrest and mortality trends, and their association with rapid response system expansion.
Austin Authors: Chen, Jack;Ou, Lixin;Hillman, Kenneth M;Flabouris, Arthas;Bellomo, Rinaldo ;Hollis, Stephanie J;Assareh, Hassan
Affiliation: Intensive Care, Royal Adelaide Hospital, Adelaide, SA, Australia
Austin Hospital, Melbourne, Victoria, Australia
University of New South Wales, Sydney, NSW, Australia
Issue Date: 4-Aug-2014
Publication information: Medical Journal of Australia; 201(3): 167-70
Abstract: To understand the changes in the population incidence of inhospital cardiopulmonary arrest (IHCA) and mortality associated with the introduction of rapid response systems (RRSs).Population-based study of 9 221 138 hospital admissions in 82 public acute hospitals in New South Wales, using data linked to a death registry, from 1 Jan 2002 to 31 Dec 2009.Changes in IHCA, IHCA-related mortality, hospital mortality and proportion of IHCA patients surviving to hospital discharge.RRS uptake increased from 32% in 2002 to 74% in 2009. This increase was associated with a 52% decrease in IHCA rate, a 55% decrease in IHCA-related mortality rate, a 23% decrease in hospital mortality rate and a 15% increase in survival to discharge after an IHCA (all P < 0.01). The adjusted absolute reductions in IHCA-related mortality and hospital mortality were 1.49 (95% CI, 1.30-1.68) and 4.05 (95% CI, 3.17-4.76) patients per 1000 admissions, respectively. The decrease in IHCA incidence rate accounted for 95% of the reduction in IHCA-related mortality. In contrast, the increase in IHCA survival accounted for only 5% of the reduction in IHCA-related mortality.During nearly a decade, as RRSs were progressively introduced, there was a coincidental reduction in IHCA, IHCA-related deaths and hospital mortality and an increased survival to hospital discharge after an IHCA. Reduced IHCA incidence, rather than improved postcardiac arrest survival, was the main contributor to the reduction in IHCA mortality.
Gov't Doc #: 25128953
Journal: Medical Journal of Australia
Type: Journal Article
Subjects: Adult
Aged, 80 and over
Heart Arrest.epidemiology.mortality.therapy
Hospital Mortality.trends
Hospital Rapid Response Team.statistics & numerical data.trends.utilization
Hospitals, Public.statistics & numerical data.trends
Logistic Models
Middle Aged
New South Wales.epidemiology
Outcome and Process Assessment (Health Care)
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