Purpose: Regionalised care at a high-volume centre is associated with better outcomes in surgery and major trauma. However, evidence for regionalised cardiac arrest care remains inconclusive. While high out-of-hospital cardiac arrest (OHCA) volume is a key feature of cardiac arrest centres (CAC), which have proven survival benefit, the role of centre volume as an independent predictor of improved outcomes is unclear. This study assesses the impact of high-volume centres on survival in nontraumatic OHCA.
Materials and methods: Medline, Embase, and Cochrane CENTRAL were searched from inception to October 11, 2021 for studies including adult nontraumatic OHCA patients treated at high-volume centres versus non-high-volume centres. Data abstraction and quality assessment were independently conducted by two authors. Main outcomes were survival and neurologically-favourable outcomes at hospital discharge or 30 days. Meta-analyses were performed for adjusted (aOR) and crude odds ratios (OR).
Results: 16 studies involving 82,769 patients were included. Five studies defined high volume as ≥40 OHCA/year, three studies as >100 OHCA/year, while all other studies differed in definitions. Survival to discharge or 30 days significantly improved with treatment at high-volume centres, regardless of whether adjusted (aOR = 1.28, 95% confidence interval [95% CI] 1.00-1.64) or crude ORs were pooled (OR = 1.43, 95% CI 1.09 to 1.87). There was no significant association between centre volume and good neurological outcomes at 30 days or hospital discharge in OHCA patients (aOR = 0.96, 95% CI 0.77 to 1.20).
Conclusion: Care at high-volume centres improved survival outcomes even after adjustment for potential confounders, but not neurologically-favourable outcomes for nontraumatic OHCA patients. More studies evaluating the relative importance of volume, compared to other variables such as the availability of treatment modalities, as a predictor of survival outcomes in OHCA patients are required.

Impact of high-volume centres on survival outcomes among nontraumatic out-of-hospital cardiac arrest patients: A systematic review and meta-analysis

Implementation of the Guidelines - How do we put the new ERC Guidelines into practice?

On 16 and 17 June, we are organising our first-ever hybrid congress. You will be able to join us live at the beautiful conference venue in Antwerp, Belgium and present your Poster. 

We are happy to welcome you to Resuscitation 2022!