title: Admission of out-of-hospital cardiac arrest victims to a high volume cardiac arrest center is linked to improved outcome.
abstract: Cardiac arrest centers have been associated with improved outcome for patients after cardiac arrest. Aim of this study was to investigate the effect on outcome depending on admission to high-, medium- or low volume centers.
  
  
  
  Analysis from a prospective, multicenter registry for out of hospital cardiac arrest patients treated by the emergency medical service of Vienna, Austria. The frequency of cardiac arrest patients admitted per center/year (low <50; medium 50-100; high >100) was correlated to favorable outcome (30-day survival with cerebral performance category of 1 or 2).
  
  
  
  Out of 2238 patients (years 2013-2015) with emergency medical service resuscitation, 861 (32% female, age 64 (51;73) years) were admitted to 7 different centers. Favorable outcome was achieved in 267 patients (31%). Survivors were younger (58 vs. 66 years; p<0.001), showed shockable initial heart rhythm more frequently (72 vs. 35%; p<0.001), had shorter CPR durations (22 vs. 29min; p<0.001) and were more likely to be treated in a high frequency center (OR 1.6; CI: 1.2-2.1; p=0.001). In multivariate analysis, age below 65 years (OR 15; CI: 3.3-271.4; p=0.001), shockable initial heart rhythm (OR 10.1; CI: 2.4-42.6; p=0.002), immediate bystander or emergency medical service CPR (OR 11.2; CI: 1.4-93.3; p=0.025) and admission to a center with a frequency of >100 OHCA patients/year (OR 5.2; CI: 1.2-21.7; p=0.025) was associated with favorable outcome.
  
  
  
  High frequency of post-cardiac arrest treatment in a specialized center seems to be an independent predictor for favorable outcome in an unselected population of patients after out of hospital cardiac arrest.
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schober
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria. Electronic address: fritz.sterz@meduniwien.ac.at.
authors.forename: Fritz
authors.initials: F
authors.lastname: Sterz
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Anton N
authors.initials: AN
authors.lastname: Laggner
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Poppe
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Patrick
authors.initials: P
authors.lastname: Sulzgruber
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Lobmeyr
authors.affiliation: Department of Anaesthesiology, General Intensive Care and Pain Management, Medical University of Vienna, Austria.
authors.forename: Philip
authors.initials: P
authors.lastname: Datler
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Keferböck
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Zeiner
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Nuernberger
authors.affiliation: Municipal Ambulance Service of Vienna, Austria.
authors.forename: Bettina
authors.initials: B
authors.lastname: Eder
authors.affiliation: 1st Medical Department, Kaiser Franz Josef Spital - SMZ Süd, Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Hinterholzer
authors.affiliation: 1st Medical Department, Kaiser Franz Josef Spital - SMZ Süd, Vienna, Austria.
authors.forename: Daniel
authors.initials: D
authors.lastname: Mydza
authors.affiliation: 2nd Medical Department, KA Rudolfstiftung, Vienna, Austria.
authors.forename: Barbara
authors.initials: B
authors.lastname: Enzelsberger
authors.affiliation: 2nd Medical Department, Emergency Unit, SMZO - Donauspital, Vienna, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Herbich
authors.affiliation: 1st Medical Department, SMZO - Donauspital, Vienna, Austria.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Schuster
authors.affiliation: 3rd Medical Department, KH Hietzing, Vienna, Austria.
authors.forename: Elke
authors.initials: E
authors.lastname: Koeller
authors.affiliation: 4th Medical Department, KH Hietzing, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Publig
authors.affiliation: 3rd Medical Department, Wilhelminenspital, Vienna, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Smetana
authors.affiliation: Pediatric Intensive Care, Department of Pediatric and Adolescent Surgery, SMZO - Donauspital, Vienna, Austria.
authors.forename: Chrisitian
authors.initials: C
authors.lastname: Scheibenpflug
authors.affiliation: 5th Medical Department, Kaiser Franz Josef Spital - SMZ Süd, Vienna, Austria.
authors.forename: Günter
authors.initials: G
authors.lastname: Christ
authors.affiliation: 4th Medical Department, Kaiser Franz Josef Spital - SMZ Süd, Vienna, Austria.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Meyer
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Uray
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy; D011446:Prospective Studies; D011787:Quality of Health Care; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cardiopulmonary resuscitation; Hospitals; Out-of-hospital cardiac arrest; Outcome assessment (health care)