title: [Differences between hospitals in prognosis after resuscitated out-of-hospital cardiac arrest patients].
abstract: BACKGROUND
  There are substantial differences in long-term survival of patients resuscitated from out-of-hospital cardiac arrest, and the level of care during hospitalization may be a contributing factor. The purpose of this study was to determine if a difference in long-term prognosis between hospitals could be detected in patients surviving cardiac arrest in Copenhagen.
  
  
  METHODS
  The mobile emergency care unit attempted resuscitation in 1,098 patients with out-of-hospital cardiac arrest in the period 2002 to 2006, among whom return of spontaneous circulation occurred in 336 (30%) of the patients admitted to hospital. Survival was determined using the Central Population Registry through Statistics Denmark.
  
  
  RESULTS
  Patients admitted to a tertiary facility were younger, more frequently male, they had more commonly ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) as their initial rhythm, and they had more frequently received bystander cardiopulmonary resuscitation. Survival at 4.6 years was 41% in patients admitted to the tertiary hospital and 10% in patients admitted to other hospitals, p < 0.0001. After adjustment for other known risk factors, patients admitted to other hospitals had a hazard ratio of 1.8 for death (95% confidence interval: 1,4-2,5) compared with patients admitted to a tertiary facility.
  
  
  CONCLUSIONS
  The survival rate after out-of-hospital cardiac arrest was significantly higher in patients admitted to a tertiary facility than among patients admitted to less specialized hospitals. Further studies are needed to identify causal factors.
authors: Kardiologisk Klinik B 2142, Hjertecentret, Rigshospitalet, DK-2100 København Ø. jesper.kjaergaard@rh.regionh.dk
authors: Jesper
authors: J
authors: Kjaergaard
authors: John
authors: J
authors: Bro-Jeppesen
authors: Lars Simon
authors: LS
authors: Rasmussen
authors: Søren Loumann
authors: SL
authors: Nielsen
authors: Fredrik
authors: F
authors: Folke
authors: Freddy
authors: F
authors: Lippert
authors: Michael C
authors: MC
authors: Wanscher
authors: Christian
authors: C
authors: Hassager
mesh_terms: D000328:Adult; D000368:Aged; D000552:Ambulances; D016507:Cardiology Service, Hospital / Q000592:standards*; D016887:Cardiopulmonary Resuscitation; D003718:Denmark / Q000453:epidemiology; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D013997:Time Factors