Table 1 Patient and hospital characteristics by hospital quartiles of endotracheal intubation during CPR
Patient characteristics | All patients N = 155,252 | 1—lowest (n = 32,825) | 2 (n = 44,535) | 3 (n = 47,480) | 4—highest (n = 30,412) | P value for trend |
Median intubation rate during CPR, % (IQR) | 71.4 (64.7, 76.7) | 57.6 (50.0, 61.3) | 67.5 (65.6, 69.0) | 75.0 (72.8, 76.4) | 80.4 (79.5, 83.1) | |
Patient demographics | ||||||
Age, mean (SD) | 67.17 (15.3) | 66.01 (15.5) | 67.02 (15.3) | 67.69 (15.1) | 67.85 (15.3) | < .001 |
Black race | 32,044 (20.6) | 5752 (17.5) | 8721 (19.6) | 10,032 (21.1) | 7539 (24.8) | < .001 |
Female sex | 64,369 (41.5) | 13,342 (40.7) | 18,576 (41.7) | 19,516 (41.1) | 12,935 (42.5) | < .001 |
Cardiac arrest characteristics | ||||||
Initial cardiac-arrest rhythm—no. (%) | < .001 | |||||
Asystole | 52,250 (33.7) | 10,088 (30.7) | 14,887 (33.4) | 16,231 (34.2) | 11,044 (36.3) | |
Pulseless electrical activity | 71,370 (46.0) | 15,437 (47.0) | 20,283 (45.5) | 21,891 (46.1) | 13,759 (45.2) | |
Pulseless ventricular tachycardia | 11,512 (7.4) | 2705 (8.2) | 3463 (7.8) | 3345 (7.1) | 1999 (6.6) | |
Ventricular fibrillation | 20,120 (13.0) | 4595 (14.0) | 5902 (13.3) | 6013 (12.7) | 3610 (11.9) | |
Hospital location of arrest—no. (%) | < .001 | |||||
Intensive care unit | 53,274 (34.3) | 12,494 (38.1) | 16,269 (36.5) | 15,463 (32.6) | 9048 (30.0) | |
Monitored unit | 35,249 (22.7) | 6513 (19.8) | 9691 (21.8) | 11,476 (24.2) | 7569 (24.9) | |
Non-monitored unit | 35,611 (22.9) | 6500 (19.8) | 9685 (21.8) | 11,170 (23.5) | 8256 (27.2) | |
Procedural areas/OR/ED | 28,749 (18.5) | 6914 (21.1) | 8231 (18.5) | 8530 (18.0) | 5074 (16.7) | |
Other | 2369 (1.5) | 404 (1.2) | 659 (1.5) | 841 (1.8) | 465 (1.5) | |
Arrest at night (11 P.M. to 7 A.M.)—no./total no. (%) | 49,611 (32.0) | 10,104 (30.8) | 14,161 (31.8) | 15,401 (32.4) | 9945 (32.7) | < .001 |
Arrest on weekend—no. (%) | 47,933 (30.9) | 10,104 (30.8) | 13,713 (30.8) | 14,746 (31.1) | 9370 (30.8) | 0.68 |
Hospital-wide response activated—no. (%) | 125,741 (81.0) | 24,342 (74.2) | 36,713 (82.4) | 40,103 (84.5) | 24,583 (80.8) | < .001 |
Preexisting conditions | ||||||
Heart failure, this admission—no. (%) | 26,227 (16.9) | 5185 (15.8) | 6717 (15.1) | 8345 (17.6) | 5980 (19.7) | < .001 |
Previous heart failure—no. (%) | 35,040 (22.6) | 7322 (22.3) | 9657 (21.7) | 10,454 (22.0) | 7607 (25.0) | < .001 |
Myocardial infarction, this admission—no. (%) | 25,132 (16.2) | 5312 (16.2) | 6979 (15.7) | 7516 (15.8) | 5325 (17.5) | < .001 |
Previous myocardial infarction—no. (%) | 25,137 (16.2) | 4948 (15.1) | 6561 (14.7) | 7533 (15.9) | 6095 (20.0) | < .001 |
Hypotension—no. (%) | 30,309 (19.5) | 6913 (21.1) | 7985 (17.9) | 9030 (19.0) | 6381 (21.0) | 0.37 |
Respiratory failure—no. (%) | 52,430 (33.8) | 11,011 (33.5) | 14,960 (33.6) | 15,938 (33.6) | 10,521 (34.6) | 0.01 |
Renal insufficiency—no. (%) | 51,151 (33.0) | 10,037 (30.6) | 14,588 (32.8) | 15,707 (33.1) | 10,819 (35.6) | < .001 |
Hepatic insufficiency—no. (%) | 9913 (6.4) | 1901 (5.8) | 2822 (6.3) | 2922 (6.2) | 2268 (7.5) | < .001 |
Metabolic or electrolyte abnormality—no. (%) | 22,673 (14.6) | 5119 (15.6) | 6015 (13.5) | 6483 (13.6) | 5056 (16.6) | 0.002 |
Diabetes mellitus—no. (%) | 50,550 (32.6) | 10,431 (31.8) | 14,159 (31.8) | 15,547 (32.7) | 10,413 (34.2) | < .001 |
Baseline depression in CNS function—no. (%) | 15,097 (9.7) | 2954 (9.0) | 3841 (8.6) | 4640 (9.8) | 3662 (12.0) | < .001 |
Acute stroke—no. (%) | 5812 (3.7) | 1260 (3.8) | 1614 (3.6) | 1724 (3.6) | 1214 (4.0) | 0.39 |
Pneumonia—no. (%) | 18,529 (11.9) | 3971 (12.1) | 5063 (11.4) | 5788 (12.2) | 3707 (12.2) | 0.09 |
Septicemia—no. (%) | 20,934 (13.5) | 4344 (13.3) | 5849 (13.1) | 6253 (13.2) | 4488 (14.8) | < .001 |
Major trauma—no. (%) | 4125 (2.7) | 1348 (4.1) | 1076 (2.4) | 1064 (2.2) | 637 (2.1) | < .001 |
Metastatic cancer—no. (%) | 18,557 (12.0) | 3478 (10.6) | 5086 (11.4) | 5873 (12.4) | 4120 (13.6) | < .001 |
Interventions in place before the arrest | ||||||
Intravenous vasopressor medication—no. (%) | 21,813 (14.1) | 5587 (17.0) | 6611 (14.8) | 6030 (12.7) | 3585 (11.8) | < .001 |
Dialysis—no. (%) | 3823 (2.5) | 783 (2.4) | 1094 (2.5) | 1010 (2.1) | 936 (3.1) | < .001 |
Intra-arterial catheter | 6652 (4.3) | 1958 (6.0) | 1966 (4.4) | 1493 (3.1) | 1235 (4.1) | < .001 |
Witnessed | 122,016 (78.6) | 26,509 (80.8) | 35,904 (80.6) | 36,711 (77.3) | 22,892 (75.3) | < .001 |
Hospital characteristics | All hospitals N = 656 | 1—lowest (n = 165) | 2 (n = 164) | 3 (n = 163) | 4—highest (n = 164) | P value for trend |
Geographic census region, number (%) | 0.66 | |||||
Northeast | 101 (15.4) | 26 (15.8) | 29 (17.7) | 22 (13.5) | 24 (14.6) | |
Midwest | 134 (20.4) | 36 (21.8) | 37 (22.6) | 28 (17.2) | 33 (20.1) | |
West | 111 (16.9) | 43 (26.1) | 30 (18.3) | 28 (17.2) | 10 (6.1) | |
South | 264 (40.2) | 39 (23.6) | 60 (36.6) | 81 (49.7) | 84 (51.2) | |
Unknown | 46 (7.0) | 21 (12.7) | 8 (4.9) | 4 (2.5) | 13 (7.9) | |
Type of hospital, number (%) | 0.95 | |||||
Teaching hospital | 319 (48.6) | 81 (49.1) | 85 (51.8) | 78 (47.9) | 75 (45.7) | |
Non-teaching hospital | 286 (43.6) | 62 (37.6) | 71 (43.3) | 80 (49.1) | 73 (44.5) | |
Unknown | 51 (7.8) | 22 (13.3) | 8 (4.9) | 5 (3.1) | 16 (9.8) | |
Location, number (%) | 0.21 | |||||
Urban | 538 (82.0) | 125 (75.8) | 142 (86.6) | 139 (85.3) | 132 (80.5) | |
Rural | 67 (10.2) | 18 (10.9) | 14 (8.5) | 19 (11.7) | 16 (9.8) | |
Unknown | 51 (7.8) | 22 (13.3) | 8 (4.9) | 5 (3.1) | 16 (9.8) | |
Ownership | 0.60 | |||||
Private | 99 (15.1) | 20 (12.1) | 22 (13.4) | 26 (16.0) | 31 (18.9) | |
Public | 511 (77.9) | 124 (75.2) | 134 (81.7) | 133 (81.6) | 120 (73.2) | |
Unknown | 46 (7.0) | 21 (12.7) | 8 (4.9) | 4 (2.5) | 13 (7.9) | |
Bed size, number (%) | 0.35 | |||||
< 100 | 57 (8.7) | 22 (13.3) | 9 (5.5) | 13 (8.0) | 13 (7.9) | |
100–499 | 414 (63.1) | 92 (55.8) | 114 (69.5) | 109 (66.9) | 99 (60.4) | |
≥ 500 | 130 (19.8) | 30 (18.2) | 30 (18.3) | 33 (20.3) | 37 (22.6) | |
Unknown | 55 (8.4) | 21 (12.7) | 11 (6.7) | 8 (4.9) | 15 (9.2) | |