title: National trends in the use of postcardiac arrest therapeutic hypothermia and hospital factors influencing its use.
abstract: BACKGROUND
  Therapeutic hypothermia (TH) in cardiac arrest continues to be underused in the United States. A better understanding of its utilization could inform future efforts and policies to improve utilization. This study investigates trends in TH use for in and out-of-hospital cardiac arrest, and hospital factors associated with its use.
  
  
  METHODS
  We performed a cross-sectional analysis using the Nationwide Inpatient Sample (NIS), 2007-2010, of US adult hospitalizations with cardiac arrest. Annual rates of TH use and proportions of hospitals using TH were calculated using NIS weighting. Potential hospital factors associated with increased likelihood of TH utilization were assessed using logistic regression.
  
  
  RESULTS
  Across 2007-2010, 1.35% of cardiac arrest patients received TH; increasing from 0.34% (2007) to 2.49% (2010). The proportion of hospitals using TH was 13.63%, increasing from 4.63% (2007) to 22.16% (2010). Significant hospital factors associated with TH utilization were: large hospitals, urban location, Northeast or West regions, teaching hospitals, non-safety net hospitals, increasing year, and hospitals with higher annual cardiac arrest volume.
  
  
  CONCLUSIONS
  Utilization of TH in cardiac arrest remains low, but increased sevenfold from 2007 to 2010. The significant variability in implementation of TH, argues for nationwide best practices or regionalization of postcardiac arrest care hospitals.
authors.affiliation: 1 Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University , Chicago, Illinois.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Dresden
authors.forename: Lanty M
authors.initials: LM
authors.lastname: O'Connor
authors.forename: Charles G
authors.initials: CG
authors.lastname: Pearce
authors.forename: D Mark
authors.initials: DM
authors.lastname: Courtney
authors.forename: Emilie S
authors.initials: ES
authors.lastname: Powell
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D006323:Heart Arrest / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007036:Hypothermia, Induced / Q000706:statistics & numerical data / Q000639:trends*; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy; D012044:Regression Analysis; D014481:United States