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Updating the model for Risk-Standardizing survival for In-Hospital cardiac arrest to facilitate hospital comparisons

BACKGROUND: Risk-standardized survival rates (RSSR) for in-hospital cardiac arrest (IHCA) have been widely used for hospital benchmarking and research. The novel coronavirus 2019 (COVID-19) pandemic has led to a substantial decline in IHCA survival as COVID-19 infection is associated with markedly l...

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Autores principales: Chan, Paul S., Kennedy, Kevin F., Girotra, Saket
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier B.V. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9811915/
https://www.ncbi.nlm.nih.gov/pubmed/36610502
http://dx.doi.org/10.1016/j.resuscitation.2022.109686
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author Chan, Paul S.
Kennedy, Kevin F.
Girotra, Saket
author_facet Chan, Paul S.
Kennedy, Kevin F.
Girotra, Saket
author_sort Chan, Paul S.
collection PubMed
description BACKGROUND: Risk-standardized survival rates (RSSR) for in-hospital cardiac arrest (IHCA) have been widely used for hospital benchmarking and research. The novel coronavirus 2019 (COVID-19) pandemic has led to a substantial decline in IHCA survival as COVID-19 infection is associated with markedly lower survival. Therefore, there is a need to update the model for computing RSSRs for IHCA given the COVID-19 pandemic. METHODS: Within Get With The Guidelines®-Resuscitation, we identified 53,922 adult patients with IHCA from March, 2020 to December, 2021 (the COVID-19 era). Using hierarchical logistic regression, we derived and validated an updated model for survival to hospital discharge and compared the performance of this updated RSSR model with the previous model. RESULTS: The survival rate was 21.0% and 20.8% for the derivation and validation cohorts, respectively. The model had good discrimination (C-statistic 0.72) and excellent calibration. The updated parsimonious model comprised 13 variables—all 9 predictors in the original model as well as 4 additional predictors, including COVID-19 infection status. When applied to data from the pre-pandemic period of 2018–2019, there was a strong correlation (r = 0.993) between RSSRs obtained from the updated and the previous models. CONCLUSION: We have derived and validated an updated model to risk-standardize hospital rates of survival for IHCA. The updated model yielded RSSRs that were similar to the initial model for IHCAs in the pre-pandemic period and can be used for supporting ongoing efforts to benchmark hospitals and facilitate research that uses data from either before or after the emergence of COVID-19.
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spelling pubmed-98119152023-01-04 Updating the model for Risk-Standardizing survival for In-Hospital cardiac arrest to facilitate hospital comparisons Chan, Paul S. Kennedy, Kevin F. Girotra, Saket Resuscitation Clinical Paper BACKGROUND: Risk-standardized survival rates (RSSR) for in-hospital cardiac arrest (IHCA) have been widely used for hospital benchmarking and research. The novel coronavirus 2019 (COVID-19) pandemic has led to a substantial decline in IHCA survival as COVID-19 infection is associated with markedly lower survival. Therefore, there is a need to update the model for computing RSSRs for IHCA given the COVID-19 pandemic. METHODS: Within Get With The Guidelines®-Resuscitation, we identified 53,922 adult patients with IHCA from March, 2020 to December, 2021 (the COVID-19 era). Using hierarchical logistic regression, we derived and validated an updated model for survival to hospital discharge and compared the performance of this updated RSSR model with the previous model. RESULTS: The survival rate was 21.0% and 20.8% for the derivation and validation cohorts, respectively. The model had good discrimination (C-statistic 0.72) and excellent calibration. The updated parsimonious model comprised 13 variables—all 9 predictors in the original model as well as 4 additional predictors, including COVID-19 infection status. When applied to data from the pre-pandemic period of 2018–2019, there was a strong correlation (r = 0.993) between RSSRs obtained from the updated and the previous models. CONCLUSION: We have derived and validated an updated model to risk-standardize hospital rates of survival for IHCA. The updated model yielded RSSRs that were similar to the initial model for IHCAs in the pre-pandemic period and can be used for supporting ongoing efforts to benchmark hospitals and facilitate research that uses data from either before or after the emergence of COVID-19. Elsevier B.V. 2023-02 2023-01-04 /pmc/articles/PMC9811915/ /pubmed/36610502 http://dx.doi.org/10.1016/j.resuscitation.2022.109686 Text en © 2023 Elsevier B.V. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Clinical Paper
Chan, Paul S.
Kennedy, Kevin F.
Girotra, Saket
Updating the model for Risk-Standardizing survival for In-Hospital cardiac arrest to facilitate hospital comparisons
title Updating the model for Risk-Standardizing survival for In-Hospital cardiac arrest to facilitate hospital comparisons
title_full Updating the model for Risk-Standardizing survival for In-Hospital cardiac arrest to facilitate hospital comparisons
title_fullStr Updating the model for Risk-Standardizing survival for In-Hospital cardiac arrest to facilitate hospital comparisons
title_full_unstemmed Updating the model for Risk-Standardizing survival for In-Hospital cardiac arrest to facilitate hospital comparisons
title_short Updating the model for Risk-Standardizing survival for In-Hospital cardiac arrest to facilitate hospital comparisons
title_sort updating the model for risk-standardizing survival for in-hospital cardiac arrest to facilitate hospital comparisons
topic Clinical Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9811915/
https://www.ncbi.nlm.nih.gov/pubmed/36610502
http://dx.doi.org/10.1016/j.resuscitation.2022.109686
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