TAILIEUCHUNG - Delayed Time to Defibrillation after In Hospital Cardiac Arrest

Expert guidelines advocate defibrillation within 2 minutes after an in-hospital cardiac arrest caused by ventricular arrhythmia. However, empirical data on the prevalence of delayed defibrillation in the United States and its effect on survival are limited. Methods We identified 6789 patients who had cardiac arrest due to ventricular fibrillation or pulseless ventricular tachycardia at 369 hospitals participating in the National Registry of Cardiopulmonary Resuscitation. Using multivariable logistic regression, we identified characteristics associated with delayed defibrillation | Delayed Time to Defibrillation after InHospital Cardiac Arrest Delayed Time to Defibrillation after In-Hospital Cardiac Arrest Paul S. Chan . Harlan M. Krumholz . Graham Nichol . . Brahmajee K. Nallamothu . . and the American Heart Association National Registry of Cardiopulmonary Resuscitation Investigators abstract background Expert guidelines advocate defibrillation within 2 minutes after an in-hospital cardiac arrest caused by ventricular arrhythmia. However empirical data on the prevalence of delayed defibrillation in the United States and its effect on survival are limited. methods We identified 6789 patients who had cardiac arrest due to ventricular fibrillation or pulseless ventricular tachycardia at 369 hospitals participating in the National Registry of Cardiopulmonary Resuscitation. Using multivariable logistic regression we identified characteristics associated with delayed defibrillation. We then examined the association between delayed defibrillation more than 2 minutes and survival to discharge after adjusting for differences in patient and hospital characteristics. results The overall median time to defibrillation was 1 minute interquartile range 1 to 3 minutes delayed defibrillation occurred in 2045 patients . Characteristics associated with delayed defibrillation included black race noncardiac admitting diagnosis and occurrence of cardiac arrest at a hospital with fewer than 250 beds in an unmonitored hospital unit and during after-hours periods 5 . to 8 . or weekends . Delayed defibrillation was associated with a significantly lower probability of surviving to hospital discharge vs. when defibrillation was not delayed adjusted odds ratio 95 confidence interval to P . In addition a graded association was seen between increasing time to defibrillation and lower rates of survival to hospital discharge for each minute of delay P for trend . From Saint Luke s Mid-America Heart .

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