Background: There is no study about comparison of clinical outcomes between in-hospital cardiac arrest (IHCA) and out-of hospital cardiac arrest (OHCA) according to hospital location and volume. The aim of the present study is to analyze clinical outcomes according to hospital location and volume between IHCA and OHCA, using a nation-wide database.

Methods: Using the Korean National Health Insurance Service Database, we had enrolled 488,129 patients (≥20 years) with claim with cardiac arrest from 2004 to 2015. The hospital-location was categorized into “Metro” (Metropolitan), “Urban” (Urban/City), “Country” (Country/Province) groups according to the Province of South Korea. And the hospital-volume was categorized into “<300” (below 300 beds), “300–499” (between 300 and 499), “>500” (over 500 beds) group. The primary outcomes were mortality within 30 days, 6 months and 1 year according to hospital location and volume between IHCA and OHCA.

Results: The total number of cardiac arrest was 488,129, of which 31.1% were in IHCA and 68.9% were in OHCA. The mortality rate only in 30 days was significantly higher in OHCA, the rate in 6 month and 1 year were significantly higher in IHCA. Among the IHCA, in “<300”, there were significantly more cardiac arrest patients than other hospitals. Otherwise, among the OHCA, in “>500”, there were significantly more cardiac arrest patients than other hospitals. The proportion of “Metro” (IHCA vs OHCA, %: 41.36 vs 42.29, p < 0.0001), “Urban” (IHCA vs OHCA, %: 40.89 vs 43.05, p < 0.0001) and “Country” (IHCA vs OHCA, %: 17.75 vs 14.66, p < 0.0001) were shown. The IHCA group showed significantly higher Charlson comorbidity score.

Conclusion: In this study, only short-term mortality was significantly higher in OHCA, significantly higher IHCA was related with “<300”, OHCA was related with “>500”, and in OHCA as well as IHCA, there were significantly more cardiac arrest patients in a dense populated location. (NRF-2017R1A2B100 5037).

6 - Comparison of Clinical Outcomes Between In-hospital Cardiac Arrest and Out-of-hospital Cardiac Arrest According to Location of Residence and Volume of Hospital: a Nation-wide Database Study