Association between Case Volume of Cardiopulmonary Resuscitation and Implementation of Therapeutic Hypothermia

ABSTRACT

PURPOSE: Therapeutic hypothermia (TH) is recommended as a strategic post-resuscitation care for favorable neurologic outcomes. However, information concerning the implementation of TH and associated number of cardiopulmonary resuscitation (CPR) volumes is lacking. METHODS: We conducted a telephone survey using a designed questionnaire from March to December, 2009. Information of target hospitals was collected from a national registry of out of hospital cardiac arrest (2006-2007). Hospital name, service levels of emergency department (ED; level 1-4), case volume of cardiopulmonary resuscitation given at each ED (high versus low volume by 34 cases per year derived from a previous sensitivity analysis study), population (metropolis exceeding one million residents), and year when TH was adopted were recorded. Demographics and factors associated with adaptation of TH were analyzed and odds ratios were calculated using a multivariate logistic regression model. RESULTS: A total of 39,833 OHCA cases for 2 years were transported to 840 hospitals. Of these hospitals, 461 (55.8%) were included for final analysis. Thirty four of the hospitals (7.4%) had adopted TH. Of these, 16 hospitals housed a high-volume ED (odds ratio=2.93). Twenty four hospitals were located in a metropolis (odds ratio=3.05) and 25 hospitals were ED level 1 or 2. CONCLUSION: Only 7.4% of surveyed Korean hospitals had adopted TH in Korea by the end of 2009. Hospitals with high-volume EDs adopted TH early, when adjusting for population and ED level.