Desperate Heroics Versus 2010 Medicine: Intensive Resource Utilization Post‐Cardiac Arrest

1Johns Hopkins University School of Medicine, Baltimore, MD

Meeting: Hospital Medicine 2011, May 10-13, Dallas, Texas.

Abstract number: 40

Background:

In an effort to standardize health care delivery and improve outcomes, agencies such as the AHA and ILCOR have developed guidelines for the initial care of the out‐of‐hospital cardiac arrest patient. These guidelines are limited in directing subsequent patient care. In the United States, such patients are always admitted to the ICU, an environment where multiple “high cost resources” (HCRs) are easily accessible and commonly utilized. However, very little has been published about resource utilization patterns or the associated expenditure in post‐cardiac arrest patients.

Methods:

We studied 167 patients admitted to our academic medical center between January 2005 and December 2009. Standard ICU care involved daily comprehensive blood tests, ECG, and chest x‐ray. A high‐cost resource, as defined in this study, included any CT/MRI imaging study, 2‐D echocardiography, venous Doppler ultrasound, electroencephalography, and sensory evoked potentials. Charges for the entire hospitalization (exclusive of physician charges) were obtained from the hospital database. We assigned a score of 1 unit each time any HCR was used. Data are means ± standard deviation.

Results:

Charges were essentially stable over the study period (2005‐2009) and were driven primarily by the cost of extensive testing rather than the length of hospital stay (see Table 1).

TABLE 1

Conclusions:

We concluded that post arrest patients in the United States undergo extensive and expensive evaluations irrespective of whether they eventually survive to discharge or die in the hospital. Published CPR survival rates in the United States are not better than those reported in countries where the access to and utilization of such resources is limited. In‐depth comparisons of clinical outcomes and resource utilization in varied health care systems are essential not only to minimize costs but also to better identify those resources that are critical to optimizing care delivery.

Disclosures:

S. M. Eid ‐ none; J. McIntyre ‐ none; S. M. Nazarian ‐ none; N. Chandra‐Strobos ‐ none

To cite this abstract:

Eid S, McIntyre J, Nazarian S, Chandra‐Strobos N. Desperate Heroics Versus 2010 Medicine: Intensive Resource Utilization Post‐Cardiac Arrest. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 40. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/desperate-heroics-versus-2010-medicine-intensive-resource-utilization-postcardiac-arrest/. Accessed April 1, 2020.

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