CoChat
Sign Up
Cited by 91Cardiac Arrest and ResuscitationPalliative Care and End-of-Life IssuesRespiratory Support and Mechanisms

Increasing survival after admission to UK critical care units following cardiopulmonary resuscitation

Open access
Nolan, J. P., Ferrando, P., Soar, J., Benger, J., Thomas, M., Harrison, D. A., Perkins, G. D.·2016·Critical Care
DOI 10.1186/s13054-016-1390-6PMC PMC4938902
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: In recent years there have been many developments in post-resuscitation care. We have investigated trends in patient characteristics and outcome following admission to UK critical care units following cardiopulmonary resuscitation (CPR) for the period 2004-2014. Our hypothesis is that there has been a reduction in risk-adjusted mortality during this period. METHODS: We undertook a prospectively defined, retrospective analysis of the Intensive Care National Audit & Research Centre (ICNARC) Case Mix Programme Database (CMPD) for the period 1 January 2004 to 31 December 2014. Admissions, mechanically ventilated in the first 24 hours in the critical care unit and admitted following CPR, defined as the delivery of chest compressions in the 24 hours before admission, were identified. Case mix, withdrawal, outcome and activity were described annually for all admissions identified as post-cardiac arrest admissions, and separately for out-of-hospital cardiac arrest and in-hospital cardiac arrest. To assess whether in-hospital mortality had improved over time, hierarchical multivariate logistic regression models were constructed, with in-hospital mortality as the dependent variable, year of admission as the main exposure variable and intensive care unit (ICU) as a random effect. All analyses were repeated using only the data from those ICUs contributing data throughout the study period. RESULTS: During the period 2004-2014 survivors of cardiac arrest accounted for an increasing proportion of mechanically ventilated admissions to ICUs in the ICNARC CMPD (9.0 % in 2004 increasing to 12.2 % in 2014). Risk-adjusted hospital mortality following admission to ICU after cardiac arrest has decreased significantly during this period (OR 0.96 per year). Over this time, the ICU length of stay and time to treatment withdrawal has increased significantly. Re-analysis including only those 116 ICUs contributing data throughout the study period confirmed all the results of the primary analysis. CONCLUSIONS: Risk-adjusted hospital mortality following admission to ICU after cardiac arrest has decreased significantly during the period 2004-2014. Over the same period the ICU length of stay and time to treatment withdrawal has increased significantly.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/s13054-016-1390-6

Cites

1 of 1 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Organ donation is generally supported by society, although levels of support vary by cultural group and between individuals.

    “Organ donation is generally supported by society, although levels of support vary by cultural group and between individuals. 181,186”

    From European Resuscitation Council Guidelines 2021: Ethics of resuscitation and end of life decisions (2021) · cites this paper as [186]

    The Discussion reports an increase in organ donation among patients who died after ICU admission, and the Methods describe collecting donor outcomes. Neither section addresses public support for organ donation or differences by cultural group or individual; searches for those attitudes found no relevant passage. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • The time-critical nature of uncontrolled donation after circulatory death usually requires the initiation of organ preservation processes prior to family consultation to maintain organ viability.

    “In particular, the time-critical nature of the process usually requires the initiation of organ preservation processes prior to family consultation to maintain organ viability. 186,190,191”

    From European Resuscitation Council Guidelines 2021: Ethics of resuscitation and end of life decisions (2021) · cites this paper as [186]

    The Discussion reports organ donation among patients who died after ICU admission following cardiac arrest, but does not describe uncontrolled donation after circulatory death or the timing of preservation procedures. Searches for organ preservation, family consultation, and donation after circulatory death found no passage addressing whether preservation usually begins before families are consulted. (LLM, conf=0.75)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 23

  1. [1]Nolan JP Laver SR Welch CA Harrison DA Gupta V Rowan K Outcome following admission to UK intensive care units after cardiac arrest: a secondary analysis of the ICNARC Case Mix Programme Database Anaesthesia. 2007 62 1207 16 10.1111/j.1365-2044.2007.05232.x 17991255 · DOI
  2. [2]Nolan JP Soar J Cariou A European Resuscitation Council and European Society of Intensive Care Medicine 2015 guidelines for post-resuscitation care Intensive Care Med. 2015 41 2039 56 10.1007/s00134-015-4051-3 26464394 · DOI
  3. [3]Nolan JP Soar J Cariou A European Resuscitation Council and European Society of Intensive Care Medicine guidelines for post-resuscitation care 2015: Section 5 of the European Resuscitation Council Guidelines for Resuscitation Resuscitation. 2015 95 201 22 10.1016/j.resuscitation.2015.07.018 26477702 · DOI
  4. [4]Sasson C Rogers MA Dahl J Kellermann AL Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis Circ Cardiovasc Qual Outcomes. 2010 3 63 81 10.1161/CIRCOUTCOMES.109.889576 20123673 · DOI
  5. [5]Girotra S Nallamothu BK Spertus JA Trends in survival after in-hospital cardiac arrest N Engl J Med. 2012 367 1912 20 10.1056/NEJMoa1109148 23150959 PMC3517894 · DOI · Paper page
  6. [6]Chan PS McNally B Tang F Kellermann A Group CS Recent trends in survival from out-of-hospital cardiac arrest in the United States Circulation. 2014 130 1876 82 10.1161/CIRCULATIONAHA.114.009711 25399396 PMC4276415 · DOI
  7. [7]Fugate JE Brinjikji W Mandrekar JN Post-cardiac arrest mortality is declining: a study of the US National Inpatient Sample 2001 to 2009 Circulation. 2012 126 546 50 10.1161/CIRCULATIONAHA.111.088807 22740113 · DOI
  8. [8]Reinikainen M Oksanen T Leppanen P Mortality in out-of-hospital cardiac arrest patients has decreased in the era of therapeutic hypothermia Acta Anaesthesiol Scand. 2012 56 110 5 10.1111/j.1399-6576.2011.02543.x 22091826 · DOI
  9. [9]van der Wal G Brinkman S Bisschops LL Influence of mild therapeutic hypothermia after cardiac arrest on hospital mortality Crit Care Med. 2011 39 84 8 10.1097/CCM.0b013e3181fd6aef 20959784 · DOI
  10. [10]Carr BG Kahn JM Merchant RM Kramer AA Neumar RW Inter-hospital variability in post-cardiac arrest mortality Resuscitation. 2009 80 30 4 10.1016/j.resuscitation.2008.09.001 18952359 · DOI
  11. [11]Keenan SP Dodek P Martin C Priestap F Norena M Wong H Variation in length of intensive care unit stay after cardiac arrest: where you are is as important as who you are Crit Care Med. 2007 35 836 41 10.1097/01.CCM.0000257323.46298.A3 17255864 · DOI
  12. [12]Harrison DA Brady AR Rowan K Case mix, outcome and length of stay for admissions to adult, general critical care units in England, Wales and Northern Ireland: the Intensive Care National Audit & Research Centre Case Mix Programme Database Crit Care. 2004 8 R99 111 10.1186/cc2834 15025784 PMC420043 · DOI
  13. [13]Harrison DA Parry GJ Carpenter JR Short A Rowan K A new risk prediction model for critical care: the Intensive Care National Audit & Research Centre (ICNARC) model Crit Care Med. 2007 35 1091 8 10.1097/01.CCM.0000259468.24532.44 17334248 · DOI
  14. [14]Kaukonen KM Bailey M Suzuki S Pilcher D Bellomo R Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012 JAMA. 2014 311 1308 16 10.1001/jama.2014.2637 24638143 · DOI
  15. [15]Nielsen N Wetterslev J Cronberg T Targeted temperature management at 33 degrees C versus 36 degrees C after cardiac arrest N Engl J Med. 2013 369 2197 206 10.1056/NEJMoa1310519 24237006 · DOI
  16. [16]Perman SM Kirkpatrick JN Reitsma AM Timing of neuroprognostication in postcardiac arrest therapeutic hypothermia Crit Care Med. 2012 40 719 24 10.1097/CCM.0b013e3182372f93 22080630 PMC3712858 · DOI
  17. [17]Grossestreuer AV Abella BS Leary M Time to awakening and neurologic outcome in therapeutic hypothermia-treated cardiac arrest patients Resuscitation. 2013 84 1741 6 10.1016/j.resuscitation.2013.07.009 23916554 · DOI
  18. [18]Sandroni C Cavallaro F Callaway CW Predictors of poor neurological outcome in adult comatose survivors of cardiac arrest: a systematic review and meta-analysis. Part 2: Patients treated with therapeutic hypothermia Resuscitation. 2013 84 1324 38 10.1016/j.resuscitation.2013.06.020 23831242 · DOI
  19. [19]Sandroni C Cariou A Cavallaro F Prognostication in comatose survivors of cardiac arrest: an advisory statement from the European Resuscitation Council and the European Society of Intensive Care Medicine Resuscitation. 2014 85 1779 89 10.1016/j.resuscitation.2014.08.011 25438253 · DOI
  20. [20]Binks AC Murphy RE Prout RE Therapeutic hypothermia after cardiac arrest - implementation in UK intensive care units Anaesthesia. 2010 65 260 5 10.1111/j.1365-2044.2009.06227.x 20085568 · DOI
  21. [21]Sandroni C Adrie C Cavallaro F Are patients brain-dead after successful resuscitation from cardiac arrest suitable as organ donors? A systematic review Resuscitation. 2010 81 1609 14 10.1016/j.resuscitation.2010.08.037 20932627 · DOI
  22. [22]Reynolds JC Rittenberger JC Callaway CW Post Cardiac Arrest Service Patterns of organ donation among resuscitated patients at a regional cardiac arrest center Resuscitation. 2014 85 248 52 10.1016/j.resuscitation.2013.11.001 24231567 · DOI
  23. [23]Soar J Callaway CW Aibiki M Part 4: Advanced life support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Resuscitation. 2015 95 e71 e122 10.1016/j.resuscitation.2015.07.042 26477429 · DOI

Cited by

Sorted by citations

Authors
Nolan, J. P., Ferrando, P., Soar, J., Benger, J., Thomas, M., Harrison, D. A., & Perkins, G. D.
Affiliations
  • Royal United Hospital (GB)
  • Intensive Care National Audit & Research Centre (GB)
  • North Bristol NHS Trust (GB)
  • University of the West of England (GB)
  • University Hospitals Bristol NHS Foundation Trust (GB)
  • Heart of England NHS Foundation Trust (GB)
Corresponding author
Nolan, J. P.
ORCID
Venue
Critical Care
Publisher
Springer Science and Business Media LLC
Published
2016-07-09
Volume
20
Issue
1
Pages
219-219
ISSN
1364-8535 (ISSN-L)
DOI
10.1186/s13054-016-1390-6
PMC
PMC4938902
OpenAlex
W2471101456
Cited by
91
References
1
Citations by year
2026: 2 · 2025: 10 · 2024: 4 · 2023: 7 · 2022: 3 · 2021: 14 · 2020: 10 · 2019: 14 · 2018: 12 · 2017: 13 · 2015: 2
FWCI
17.21
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Critical Care (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Explore Bristol Research (publishedVersion, cc-by)
  • Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
  • UWE Research Repository (UWE Bristol) (submittedVersion, cc-by)
  • Bristol Research (University of Bristol) (submittedVersion, cc-by)
Funders
National Institute for Health and Care Research (NF-SI-0514-10139, RP-DG-0612-10004)
Topics
  • Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Keywords
post-resuscitation care, cardiopulmonary resuscitation, in-hospital mortality, risk-adjusted mortality, out-of-hospital cardiac arrest, in-hospital cardiac arrest, ICU length of stay, treatment withdrawal, mechanical ventilation, survival trends
MeSH terms
United Kingdom, Hospitalization, Humans, Intensive Care Units, Prospective Studies, Respiration, Artificial, Retrospective Studies, Survival Analysis, Cardiopulmonary Resuscitation, Out-of-Hospital Cardiac Arrest

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review