Association Between Teaching Status of Metropolitan Hospitals and Out of Hospital Cardiac Arrest Outcomes: A Retrospective Observational Study of Hospitals in the United States
Abstract
Introduction: The quality of care and patient outcome of out-of-hospital cardiac arrest (OHCA) are affected by different factors, one of which is the hospital teaching status. This study aims to assess the association between teaching status of hospitals and survival rates.
Methods: This retrospective observational study utilized the Nationwide Emergency Department Sample (NEDS) database of the year 2014 (released in 2016). The study sample included OHCA 122,776 patients. Descriptive analysis was performed. Patients’ characteristics were compared according to the hospital teaching status. This was followed by a multivariate analysis to assess the impact of the hospital teaching status on the patients’ survival at hospital discharge after controlling for confounding factors.
Results: A total of 122,776 patients with OHCA were included in this study. The average age was 65.91 years with male predominance (61.7%). Around 62.1% of patients were admitted to metropolitan teaching hospitals. Overall survival to hospital discharge was 6.4%. Survival was higher in patients who were treated in a metropolitan teaching hospital in comparison with those who presented to a metropolitan non-teaching hospital (7.2 % versus 4.9%, p<0.001). After adjusting for confounders, patients’ survival to hospital discharge was similar in the two groups (teaching and non-teaching metropolitan hospitals) (OR=0.909, 95% CI 0.776 – 1.065).
Conclusion: In this study, there was no significant association between teaching status of US metropolitan hospitals and survival of OHCA patients. OHCA patients may be transferred to the nearest hospital regardless of teaching status in US metropolitan areas.