Cardiac arrest survival rate varies widely in US, study finds

Cooperation cited as a key factor

MINNEAPOLIS - People suffering cardiac arrest outside a hospital are five times more likely to survive in Seattle than in Alabama, according to a study that found survival rates varied by geographic region in the United States.

More than 166,000 Americans go into cardiac arrest outside a hospital each year. The condition, in which the heart suddenly stops beating, is fatal in the vast majority of patients, especially if they aren't treated within minutes. The study in the Journal of the American Medical Association shows the chances of survival for cardiac arrest can be improved if communities, emergency services, and hospitals work together.

The researchers tracked the number and outcome of cardiac arrests in 10 locations across the United States and Canada, covering a population of 21.4 million people. In all, there were 20,520 episodes, and 4.6 percent survived. Survival rates ranged from 3 percent in Alabama to 16.3 percent in Seattle. If community leaders were able to narrow the variation in survival rates by improving results in low-performing areas, an estimated 15,000 deaths could be prevented each year, the researchers calculated.

"Think about how many people we could save if we improved the system," said lead researcher Graham Nichol, director of the center for pre-hospital emergency care at the University of Washington in Seattle. "We all need to do a better job."

One of the first steps is to require hospitals and emergency service providers to report the number of patients experiencing cardiac arrest to local and national health officials, such as the Centers for Disease Control and Prevention, Nichol said. The number of attacks isn't currently tracked in a systematic manner, and that makes it hard to know what needs improvement.

In the study, Seattle had the best survival rate for cardiac arrest. The next highest was Iowa, with 11 percent survival, followed by Portland at 10.6 percent. Milwaukee and Vancouver tied with a 9.7 percent survival rate.

In the bottom half of the study was Pittsburgh, with 7 percent survival, followed by Toronto at 5.5 percent, Ottawa at 5.3 percent, Dallas at 4.5 percent, and Alabama at 3 percent.