title: The impact of prolonged boarding of successfully resuscitated out-of-hospital cardiac arrest patients on survival-to-discharge rates.
abstract: OBJECTIVE
  To evaluate the effect of prolonged ED boarding of successfully resuscitated out-of-hospital cardiac arrest (OHCA) patients on their survival-to-discharge rate.
  
  
  METHODS
  This is a retrospective nationwide cohort study of OHCA patients from 2006 to 2010. OHCA patients are classified as having those with presumed cardiac aetiology but who gained a sustained return of spontaneous circulation (ROSC). Patients who were transferred to in-hospital units within 6h after ROSC were classified in the not-delayed group (the ND group), and the remaining patients were classified as the delayed group (the D group). The survival rate between the two groups using univariate and multivariate analyses with Utstein variables was compared. We also performed a sensitivity analysis using a different time standard.
  
  
  RESULTS
  During the study period, 101,463 OHCA patients were assessed by Emergency Medical Services in Korea. Of these patients, 13,330 presented with ROSC at admission, 4686 patients were selected for final analysis, 3419 were categorised in the ND group, and 1267 in the D group. After adjusting confounders with a multivariate regression model, the D group showed a significantly lower rate of survival than the ND group (OR: 0.73 [0.62-0.86]). Sensitivity analysis using different time cut-offs showed a consistently lower rate of survival in the D group, from 1 to 36h.
  
  
  CONCLUSIONS
  OHCA patients who were delayed in their transfer to in-patient units had a significantly lower survival-to-discharge rate.
authors: Samsung Medical Center, Department of Emergency Medicine, Seoul, Republic of Korea; Seoul National University Hospital Biomedical Research Institute, Laboratory of Emergency Medical Services, Seoul, Republic of Korea.
authors: Won Chul
authors: WC
authors: Cha
authors: Gachon University Gil Medical Center, Department of Emergency Medicine, Incheon, Republic of Korea; Seoul National University Hospital Biomedical Research Institute, Laboratory of Emergency Medical Services, Seoul, Republic of Korea. Electronic address: truecho@hanmail.net.
authors: Jin Seong
authors: JS
authors: Cho
authors: Seoul National University Hospital, Department of Emergency Medicine, Seoul, Republic of Korea; Seoul National University Hospital Biomedical Research Institute, Laboratory of Emergency Medical Services, Seoul, Republic of Korea.
authors: Sang Do
authors: SD
authors: Shin
authors: Seoul National University Hospital, Department of Emergency Medicine, Seoul, Republic of Korea; Seoul National University Hospital Biomedical Research Institute, Laboratory of Emergency Medical Services, Seoul, Republic of Korea.
authors: Eui Jung
authors: EJ
authors: Lee
authors: Seoul National University College of Medicine, JW LEE Center for Global Medicine, Seoul, Republic of Korea; Seoul National University Hospital Biomedical Research Institute, Laboratory of Emergency Medical Services, Seoul, Republic of Korea.
authors: Young Sun
authors: YS
authors: Ro
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation; D015331:Cohort Studies; D003441:Crowding; D004636:Emergency Service, Hospital; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy*; D010343:Patient Admission; D010351:Patient Discharge; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D061665:Time-to-Treatment
keywords: Crowding; Fatal outcome; Out-of-hospital cardiac arrest; Time-to-treatment