The survival rates of patients experiencing cardiac arrest may vary significantly based on which EMS agency gave initial treatment, with the odds of surviving to hospital discharge varying by over 50 percent for two similar patients treated by two randomly selected EMS agencies, a study published in JAMA Cardiology found.
"We found large outcome variations between EMS agencies that come after a cardiac arrest even after adjusting for many factors," lead study author Masashi Okubo, MD, told The Washington Post.
The researchers looked at about 43,000 patients treated from 2011-15 by 112 EMS agencies. After examining patients who survived long enough to be discharged from the hospital, the researchers found large differences among agencies. The worst-performing agency had zero survivors out of 36 patients treated (0 percent), compared to 66 survivors out of 228 patients treated (about 30 percent) for the best-performing agency.
They found a similar pattern when looking at patients' recovery of function by the time they were discharged. In this category, the worst-performing agency had favorable functional recovery in zero out of 87 patients (0 percent) and the best had favorable functional recovery in 11 out of 54 patients (20 percent).
More research is needed to determine why certain EMS agencies performed better than others, Dr. Okubo said.
"These findings suggest that dissemination of best practices and use of formal quality improvement programs by community-based EMS agencies may help to improve quality and outcomes in cardiac arrest," Gregg Fonarow, MD, professor of cardiovascular medicine and science at the David Geffen School of Medicine at UCLA, told the Post.