Cardiac arrest: go the extra mile for a specialist centre

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Survival rates are better when out-of-hospital cardiac arrest patients are admitted directly to a specialist cardiac centre, regardless of distance.

Patients who suffer an out-of- hospital cardiac arrest (OHCA) are significantly more likely to survive if they are immediately transferred to a specialist cardiac centre than the nearest general hospital, according to research published this week in the European Heart Journal . Distance to the nearest specialist centre did not affect the odds of survival.

The study of more than 41,000 unselected patients who experienced an OHCA between 2001 and 2013, found lower mortality was linked with direct admission to an invasive heart centre, and receipt of coronary angiography (CAG) and percutaneous coronary intervention (PCI).

Of the total cohort, just 9 per cent of patients were still alive after 30 days. Almost 30 per cent of participants were admitted directly to an invasive heart centre, while the majority were admitted to a local hospital. More than 20 per cent of patients who achieved return of spontaneous circulation had undergone CAG and 15 per cent had PCI performed after CAG.

Compared with other cardiac arrest patients, direct admission to an invasive heart centre was associated with an 11 per cent improvement in 30-day survival odds, and undergoing CAG/PCI was linked to a 45 per cent greater chance of survival.

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