For hospital patients, defibrillation delays mean lower survival

Jan 02, 2008

[B]30 percent of patients receive life-saving defibrillation more than two minutes after cardiac arrest[/B]
An estimated 750,000 hospitalized patients experience cardiac arrest and undergo CPR annually, and less than 30 percent of those leave the hospital alive.

In a paper published in the Jan. 3 issue of the New England Journal of Medicine, researchers quantified the impact of receiving a life-saving electrical shock (defibrillation) among hospitalized patients experiencing a form of cardiac arrest known as ventricular arrhythmia. They found that the chances of survival for hospitalized patients improve dramatically if defibrillation is administered within the expert-recommended two minutes following a cardiac arrest.

Analyzing data from the National Registry of Cardiopulmonary Resuscitation, the authors concluded that 30 percent of patients with cardiac arrest due to ventricular arrhythmia received life-saving defibrillation more than two minutes after initial recognition of their cardiac arrest, a delay that exceeds guidelines-based recommendations. The delayed defibrillation was linked to a significantly lower probability of survival to hospital discharge — 22 percent vs. 39 percent when defibrillation wasn’t delayed—and a 26 percent lower likelihood among survivors of being discharged without major neurological impairment.

The findings also revealed certain hospital characteristics were associated with delayed defibrillation, including small hospital size (fewer than 250 beds); occurrence of cardiac arrest in hospitalized patients whose heart rhythm was not being constantly monitored in specialized units; and occurrence of cardiac arrest after-hours (i.e., nights and weekends).

“While several prior studies have shown an association between defibrillation time and survival, these were relatively small studies that typically included patients whose arrest rhythms would not have benefited from defibrillation” said lead study author Paul S. Chan, M.D, a cardiologist and researcher from Saint Luke’s Mid America Heart Institute. Dr. Chan was previously with the University of Michigan where he initiated the study with University of Michigan cardiologist Brahmajee Nallamothu, M.D., M.P.H., the new paper’s senior author.

The study used a larger, more statistically significant registry of nearly 7,000 patients and focused exclusively on appropriate patients with ventricular arrhythmia. “We found that delayed defibrillation was common, and that rapid defibrillation was associated with sizable survival gains in these high-risk patients,” said Dr. Chan. “However, the real work has yet to be done in this field. We now have to develop systems of care within the hospital to improve defibrillation times nationally.”

“These findings represent a real opportunity to improve patient care,” said Dr. Nallamothu. “We need to understand how delayed defibrillation, which was more common after-hours and in unmonitored settings, relates to the immediate availability of medical personnel or equipment, as well as potential delays in recognition of ventricular arrhythmia.”


Source: University of Michigan Health System

Explore further: Experts call for higher exam pass marks to close performance gap between international and UK medical graduates

add to favorites email to friend print save as pdf

Related Stories

Are ICDs up to par with patients living longer?

Apr 04, 2011

Most patients with ischemic cardiomyopathy (ICM) and dilated cardiomyopathy (DCM) who have an implantable cardioverter-defibrillator (ICD) now live more than seven years and those ICD patients with hereditary heart disease ...

Recommended for you

What are the chances that your dad isn't your dad?

Apr 16, 2014

How confident are you that the man you call dad is really your biological father? If you believe some of the most commonly-quoted figures, you could be forgiven for not being very confident at all. But how ...

New technology that is revealing the science of chewing

Apr 15, 2014

CSIRO's 3D mastication modelling, demonstrated for the first time in Melbourne today, is starting to provide researchers with new understanding of how to reduce salt, sugar and fat in food products, as well ...

After skin cancer, removable model replaces real ear

Apr 11, 2014

(HealthDay)—During his 10-year struggle with basal cell carcinoma, Henry Fiorentini emerged minus his right ear, and minus the hearing that goes with it. The good news: Today, the 56-year-old IT programmer ...

User comments : 0

More news stories

Researchers successfully clone adult human stem cells

(Phys.org) —An international team of researchers, led by Robert Lanza, of Advanced Cell Technology, has announced that they have performed the first successful cloning of adult human skin cells into stem ...