Summary

Characteristics, management, and prognosis of out-of-hospital cardiac arrest of cardiac cause according to the treating center

Pablo Jorge-Pérez1, Ana Viana-Tejedor2, Cristina Fernández3-5, Francisco Javier Elola3, Náyade del Prado6, María Isabel Barrionuevo Sánchez7, Marta M. Martín-Cabeza1, José Luis Bernal3, Rut Andrea-Riba8, Albert Ariza-Solé7

Affiliation of the authors

1Complejo Hospitalario Universitario de Canarias, Tenerife, Spain. 2Hospital Clínico San Carlos, Madrid, Spain. 3Fundación Instituto para la Mejora de la Asistencia Sanitaria (IMAS). Madrid, Spain. Cátedra IMAS – Universidad Rey Juan Carlos. 4Servicio de Medicina Preventiva, Área Sanitaria De Santiago de Compostela y Barbanza, Spain. 5Instituto de Investigaciones Sanitarias de Santiago (idis), Spain. 6Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain. 7Servicio de Cardiología, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain. Bioheart, Grup de Malalties Cardiovasculars, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain. 8Instituto Cardiovascular, Hospital Clinic Barcelona, Universidad de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.

DOI

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Jorge-Pérez P, Viana-Tejedor A, Fernández C, Elola FJ, del Prado N, Barrionuevo Sánchez MI, et al. Characteristics, management, and prognosis of out-of-hospital cardiac arrest of cardiac cause according to the treating center. Emergencias. 2026;38:20-6

Summary

Introduction. Out-of-hospital cardiac arrest (OHCA) is a major public health problem associated with high mortality and disability. Hospital care in Spain is heterogeneous. This study analyzes the impact of hospital type and interhospital transfers on the management and prognosis of patients with OHCA.

Methods.

We conducted a retrospective, population-based study (2016–2022) was using the Minimum Basic Data Set of patients aged > 18 years with a diagnosis of OHCA due to an underlying cardiac cause. Episodes were categorized into 3 groups: admission to hospitals without (Group 1) and with (Group 3) a cath lab; and Group 2: transfer from a Group 1 hospital to a Group 3 hospital. Outcome variables included in-hospital mortality and cerebral anoxia. Multilevel logistic regression models were used for risk adjustment.

Results.

A total of 6,379 episodes were analyzed. The overall mortality rate was 42.7%. Cerebral anoxia (OR, 5.8; 95% CI, 4.97–6.88) and chronic liver disease (OR, 2.61; 95% CI, 1.88–3.61) were the main predictors of mortality. Belonging to Group 2 (OR, 0.27; 95% CI, 0.17–0.41) and Group 3 (OR, 0.81; 95% CI, 0.68 0.96) had a protective effect. Centers with a higher number of discharges for circulatory system diseases showed a lower risk-adjusted mortality rate.
Conclusion. There are differences in the hospital management of OHCA in Spain. The availability of PCI capable centers and a higher volume of circulatory system cases offer a better prognosis. The limited centralization of care suggests opportunities for organizational improvement to optimize outcomes.

 

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