Advanced cardiac life support training improves long-term survival from in-hospital cardiac arrest.
BACKGROUND
Advanced cardiac life support (ACLS) training was introduced to bring order and a systematic approach to the treatment of cardiac arrest by professional responders. In spite of the wide dissemination of ACLS training, it has been difficult to demonstrate improved outcome following such training.


OBJECTIVE
To determine the value of formal ACLS training in improving survival from in-hospital cardiac arrest.


METHODS
A multi-center, prospective cohort study examined patient outcomes after resuscitation efforts by in-hospital rescue teams with and without ACLS-trained personnel. A total of 156 patients, experiencing 172 in-hospital cardiopulmonary arrest events over a 38-month period (January 1998 to March 2001) were studied.


METHODS
Primary endpoints included return of spontaneous circulation (ROSC), survival to hospital discharge, 30-day survival, and 1-year survival.


RESULTS
The immediate success of resuscitation efforts for all patients was 39.7% (62/156). There was a significant increase in ROSC with ACLS-trained personnel (49/113; 43.4%) versus no ALCS-trained personnel (16/59; 27.1%; p=0.04). Likewise, patients treated by ACLS-trained personnel had increased survival to hospital discharge (26/82; 31.7% versus 7/34; 20.6%; p=0.23), significantly better 30-day survival (22/82; 26.8% versus 2/34; 5.9%; p<0.02), and significantly improved 1-year survival (18/82; 21.9% versus 0/34; 0%; p<0.002).


CONCLUSIONS
The presence of at least one ACLS-trained team member at in-hospital resuscitation efforts increases both short and long-term survival following cardiac arrest.
Moretti
Miguel Antonio
MA
Heart Institute (INCOR) at the University of Sao Paulo, Sao Paulo, Brazil.
Cesar
Luiz Antonio Machado
LA
Nusbacher
Amit
A
Kern
Karl B
KB
Timerman
Sergio
S
Ramires
José Antonio Franchini
JA
D022561:Advanced Cardiac Life Support / Q000193:education* / Q000379:methods*; D001938:Brazil / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome