Table 3.
Baseline Hospital and Patient Characteristics by Hospital Adherence Quartilea
| Overallb | 1st Quartilec (Lowest) | 2nd Quartiled | 3rd Quartilee | 4th Quartilef (Highest) | p-value | |
|---|---|---|---|---|---|---|
| (n=261) | (n=65) | (n=65) | (n=65) | (n=65) | ||
| Hospital characteristicsg | ||||||
| Hospital type | ||||||
| Teaching (major or minor) | 144 (55.2) | 27 (41.5) | 33 (50.8) | 42 (63.6) | 42 (64.6) | 0.003 |
| Trauma services (level 1,2) | 107 (45.7) | 27 (49.1) | 22 (37.9) | 34 (56.7) | 24 (39.3) | 0.72 |
| Cardiac surgery capabilities | 172 (73.5) | 35 (63.6) | 44 (75.9) | 48 (80.0) | 45 (73.8) | 0.21 |
| Hospital bed size | 0.01 | |||||
| Small (<250 beds) | 91 (34.9) | 31 (47.7) | 25 (38.5) | 15 (22.7) | 20 (30.8) | |
| Medium (250–499 beds) | 109 (41.8) | 22 (33.8) | 27 (41.5) | 31 (47.0) | 29 (44.6) | |
| Large (≥500 beds) | 61 (23.4) | 12 (18.5) | 13 (20.0) | 20 (30.3) | 16 (24.6) | |
| Nurse-to-bed ratio | 0.02 | |||||
| <1 | 16 (6.1) | 8 (12.3) | 2 (3.1) | 4 (6.1) | 2 (3.1) | |
| ≥1, <1.5 | 76 (29.1) | 25 (38.5) | 20 (30.8) | 14 (21.2) | 17 (26.2) | |
| ≥1.5, <2 | 89 (34.1) | 17 (26.2) | 20 (30.8) | 30 (45.5) | 22 (33.8) | |
| ≥2, <2.5 | 56 (21.5) | 8 (12.3) | 18 (27.7) | 13 (19.7) | 17 (26.2) | |
| ≥2.5, <3 | 16 (6.1) | 5 (7.7) | 3 (4.6) | 4 (6.1) | 4 (6.2) | |
| ≥3 | 8 (3.1) | 2 (3.1) | 2 (3.1) | 1 (1.5) | 3 (4.6) | |
| Percentage of ICU beds | 0.87 | |||||
| Low (<5%) | 49 (18.8) | 17 (26.2) | 7 (10.8) | 8 (12.1) | 17 (26.2) | |
| Medium (5–10%) | 155 (59.4) | 33 (50.8) | 42 (64.6) | 46 (69.7) | 34 (52.3) | |
| High (>10%) | 26 (10.0) | 5 (7.7) | 6 (9.2) | 6 (9.1) | 9 (13.8) | |
| Geographic region | 0.56 | |||||
| Northeast | 40 (15.3) | 10 (15.4) | 12 (18.5) | 11 (16.7) | 7 (10.8) | |
| South | 116 (44.4) | 27 (41.5) | 29 (44.6) | 28 (42.4) | 32 (49.2) | |
| Midwest | 52 (19.9) | 15 (23.1) | 11 (16.9) | 14 (21.2) | 12 (18.5) | |
| West | 53 (20.3) | 13 (20.0) | 13 (20.0) | 13 (19.7) | 14 (21.5) | |
| Location | 0.08 | |||||
| Urban | 240 (92.0) | 55 (84.6) | 62 (95.4) | 63 (95.5) | 60 (92.3) | |
| Rural | 21 (8.0) | 10 (15.4) | 3 (4.6) | 3 (4.5) | 5 (7.7) | |
| Ownership | 0.42 | |||||
| Private | 34 (13.0) | 11 (16.9) | 5 (7.7) | 9 (13.6) | 9 (13.8) | |
| Government | 42 (16.1) | 12 (18.5) | 10 (15.4) | 8 (12.1) | 12 (18.5) | |
| Non-profit | 185 (70.9) | 42 (64.6) | 50 (76.9) | 49 (74.2) | 44 (67.7) | |
| Patient characteristics | ||||||
| Demographics | ||||||
| Age, yr, median (IQR) | 67 (56,78) | 69 (57,79) | 68 (57,79) | 66 (55,77) | 66 (55,77) | <0.001 |
| Male | 20,428 (57.9) | 2,695 (58.9) | 4,729 (60.0) | 6,224 (57.1) | 6,780 (56.9) | <0.001 |
| Race | <0.001 | |||||
| White | 23,612 (67.3) | 3,257 (71.6) | 5,621 (71.6) | 6,901 (64.0) | 7,833 (66.0) | |
| Black | 7,615 (21.7) | 739 (16.2) | 1,412 (18.0) | 2,615 (24.2) | 2,849 (24.0) | |
| Asian/Pacific Islander | 439 (1.3) | 61 (1.3) | 62 (0.8) | 141 (1.3) | 175 (1.5) | |
| American Indian/Eskimo | 132 (0.4) | 27 (0.6) | 27 (0.3) | 48 (0.4) | 30 (0.3) | |
| Hispanic | 1,672 (4.8) | 169 (3.7) | 244 (3.1) | 631 (5.8) | 628 (5.3) | |
| Other | 1,589 (4.5) | 299 (6.6) | 483 (6.2) | 453 (4.2) | 354 (3.0) | |
| Cardiac arrest characteristics | ||||||
| Initial rhythm | <0.001 | |||||
| VF/pulseless VT | 5,547 (17.1) | 742 (18.4) | 1,257 (17.4) | 1,690 (16.8) | 1,858 (16.7) | |
| Asystole/PEA | 26,845 (82.9) | 3,290 (81.6) | 5,949 (82.6) | 8,342 (83.2) | 9,264 (83.3) | |
| Location of arrest | <0.001 | |||||
| ICU | 21,698 (61.5) | 2,514 (54.9) | 4,449 (56.4) | 6,889 (63.2) | 7,846 (65.8) | |
| Monitored unit | 6,788 (19.2) | 732 (16.0) | 1,577 (20.0) | 2,120 (19.4) | 2,359 (19.8) | |
| Non-monitored unit | 6,797 (19.3) | 1,330 (29.1) | 1,857 (23.6) | 1,891 (17.3) | 1,719 (14.4) | |
| Time of arrest | ||||||
| Arrest at night (11pm–7am) | 13,293 (38.0) | 1,781 (39.8) | 3,078 (39.4) | 4,053 (37.5) | 4,381 (36.9) | <0.001 |
| Arrest on weekend | 9,796 (27.8) | 1,213 (26.6) | 2,204 (28.0) | 3,014 (27.7) | 3,365 (28.2) | 0.10 |
| Recurrent IHCA after index IHCA | 5343 (15.1) | 573 (12.5) | 1114 (14.1) | 1706 (15.7) | 1950 (16.4) | <0.001 |
| Preexisting conditions | ||||||
| MI during admission | 3,556 (13.7) | 414 (11.3) | 815 (13.2) | 1,164 (14.5) | 1,163 (14.4) | <0.001 |
| Prior MI | 3,525 (13.6) | 440 (12.0) | 760 (12.3) | 1,272 (15.9) | 1,053 (13.1) | 0.02 |
| Arrhythmia | 7,614 (29.4) | 895 (24.5) | 1,915 (31.0) | 2,702 (33.7) | 2,102 (26.1) | 0.20 |
| CHF during admission | 4,466 (17.2) | 548 (15.0) | 1,010 (16.4) | 1,405 (17.5) | 1,503 (18.7) | <0.001 |
| Prior CHF | 5,284 (20.4) | 758 (20.7) | 1,215 (19.7) | 1,729 (21.6) | 1,582 (19.6) | 0.49 |
| Diabetes mellitus | 8,125 (31.4) | 1,089 (29.8) | 1,929 (31.3) | 2,510 (31.3) | 2,597 (32.2) | 0.01 |
| Malignancy | 3,176 (12.3) | 410 (11.2) | 660 (10.7) | 1,059 (13.2) | 1,047 (13.0) | <0.001 |
| HIV positive | 241 (0.9) | 39 (1.1) | 43 (0.7) | 69 (0.9) | 90 (1.1) | 0.14 |
| AIDS | 159 (0.6) | 23 (0.6) | 28 (0.5) | 43 (0.5) | 65 (0.8) | 0.04 |
| Stroke | 981 (3.8) | 133 (3.6) | 215 (3.5) | 289 (3.6) | 344 (4.3) | 0.02 |
| Respiratory insufficiency | 11,180 (43.2) | 1,161 (31.7) | 2,438 (39.5) | 3,652 (45.6) | 3,929 (48.8) | <0.001 |
| Pneumonia | 3,984 (15.4) | 532 (14.5) | 997 (16.2) | 1,134 (14.1) | 1,321 (16.4) | 0.10 |
| Hepatic insufficiency | 1,984 (7.7) | 290 (7.9) | 425 (6.9) | 647 (8.1) | 622 (7.7) | 0.39 |
| Renal insufficiency | 9,485 (36.6) | 1,158 (31.6) | 2,122 (34.4) | 3,058 (38.1) | 3,147 (39.1) | <0.001 |
| Septicemia | 4,665 (18.0) | 516 (14.1) | 1,020 (16.5) | 1,537 (19.2) | 1,592 (19.8) | <0.001 |
| Metabolic/electrolyte abnormality | 3,794 (14.6) | 432 (11.8) | 774 (12.5) | 1,306 (16.3) | 1,282 (15.9) | <0.001 |
| Illness category | <0.001 | |||||
| Medical | 27,442 (77.8) | 3,591 (78.5) | 6,289 (79.8) | 8,571 (78.6) | 8,991 (75.4) | |
| Surgical | 7,646 (21.7) | 821 (17.9) | 1,577 (20.0) | 2,320 (21.3) | 2,928 (24.6) | |
| Interventions in place at the time of event | ||||||
| Vascular access | 33,197 (94.1) | 4,171 (91.1) | 7,169 (90.9) | 10,363 (95.1) | 11,494 (96.4) | <0.001 |
| Arterial catheter | 4,442 (36.1) | 349 (21.4) | 695 (27.1) | 1,596 (42.2) | 1,802 (41.6) | <0.001 |
| Vasopressors | 2,598 (28.5) | 226 (18.9) | 466 (23.0) | 871 (30.8) | 1,035 (33.8) | <0.001 |
| Hemodialysis | 1,084 (13.6) | 124 (11.0) | 212 (11.5) | 280 (11.7) | 468 (17.9) | <0.001 |
| IABP | 472 (6.3) | 41 (3.9) | 108 (6.1) | 154 (6.7) | 169 (7.1) | 0.001 |
| Mechanical ventilation | 12,028 (67.1) | 1,287 (56.1) | 2,326 (62.4) | 4,174 (72.2) | 4,241 (69.3) | <0.001 |
| Length of stay, days, median (IQR) | 6 (2, 15) | 5 (2, 12) | 5 (2, 14) | 6 (2, 15) | 7 (2, 17) | <0.001 |
| CPC score at hospital discharge, mean (SD) | 4.3 (1.5) | 4.3(1.5) | 4.3 (1.4) | 4.3 (1.4) | 4.2 (1.5) | <0.001 |
Abbreviations: AIDS, acquired immune deficiency syndrome; CHF, congestive heart failure; CPC, cerebral performance category; IABP, intra-aortic balloon pump; ICU, intensive care unit; IQR, interquartile range; HIV, human immunodeficiency virus; MI, myocardial infarction; PA, pulmonary artery; PEA, pulseless electrical activity; SD, standard deviation; All other abbreviations can be found in Table 1.
a
Quartiles are divided into equal hospital quartiles based on sequentially ordered composite quality performance scores
b
Overall population: 35,283 patients
c
Quartile 1 population: 4,576 patients
d
Quartile 2 population: 7,883 patients
e
Quartile 3 population: 10,900 patients
f
Quartile 4 population: 11,923 patients
g
All percentages are based on non-missing values.