Cardiac arrest center – One-year experience of the Regional Hospital Liberec

Abstract

IntroductionOut-of-hospital cardiac arrest (OHCA) is one of the most common causes of death in the adult population in developed countries. Centralization of post-resuscitation care may improve the patients’ prognosis. Expert statement of the Czech Society of Cardiology recommends the establishment of cardiac arrest centers using the infrastructure of existing tertiary cardiac centers. The introduction of this system in the region of Liberec started in April 2016. The aim of our work is to present the one-year results compared to the results from previous years. MethodsAll patients treated in the Department of Cardiology of Regional Hospital Liberec after OHCA from 1st April 2016 to 1st April 2017 were enrolled consecutively. Neurological status and mortality were evaluated for the time period of 30 days from the day of admission. The data were compared to the registry of patients hospitalized in the same department after OHCA and successful resuscitation from 1st January 2013 to 31st November 2015. ResultsAfter the establishment of the Cardiac Arrest Centre, an increase of primarily transported patients of 39.5% (0.81 vs. 1.13 patient per week) was observed. There was a statistically significant increase in the proportion of patients with non-shockable rhythm (25.2 vs. 42.6%, p: 0.013). Despite this, the proportion of patients with cardiovascular etiology of cardiac arrest did not change (71.4 vs. 77.0%). There was also no reduction in the proportion of patients with acute coronary syndrome (47.6 vs. 44.3%). There was no statistically significant change of proportion of patients undergoing selective coronarography (63.9 vs. 54.1%) and percutaneous coronary intervention (35.4 vs. 36.1%). There was an increase in 30-day mortality, which was not statistically significant (36.7 vs. 49.2%, p: 0.096). Most of the surviving patients (75.4 vs. 71.0%) were in a good neurological condition. ConclusionCentralization of post cardiac arrest care using previously established infrastructure is feasible in our region. Furthermore, it resulted in the increase of directly transported patients and led to the increase of the total number of patients admitted without increasing the proportion of patients with a non-cardiac cause of OHCA. There was no significant change in mortality and neurological outcome.