{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T20:31:47Z","timestamp":1791577907807,"version":"4.3.4"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2014,11,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Despite intensive efforts over many years, the United States has made limited progress in improving rates of survival from out-of-hospital cardiac arrest. Recently, national organizations, such as the American Heart Association, have focused on promoting bystander cardiopulmonary resuscitation, use of automated external defibrillators, and other performance improvement efforts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      Using the Cardiac Arrest Registry to Enhance Survival (CARES), a prospective clinical registry, we identified 70\u2009027 U.S. patients who experienced an out-of-hospital cardiac arrest between October 2005 and December 2012. Using multilevel Poisson regression, we examined temporal trends in risk-adjusted survival. After adjusting for patient and cardiac arrest characteristics, risk-adjusted rates of out-of-hospital cardiac arrest survival increased from 5.7% in the reference period of 2005 to 2006 to 7.2% in 2008 (adjusted risk ratio, 1.27; 95% confidence interval, 1.12\u20131.43;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Survival improved more modestly to 8.3% in 2012 (adjusted risk ratio, 1.47; 95% confidence interval, 1.26\u20131.70;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). This improvement in survival occurred in both shockable and nonshockable arrest rhythms (\n                      <jats:italic>P<\/jats:italic>\n                      for interaction=0.22) and was also accompanied by better neurological outcomes among survivors (\n                      <jats:italic>P<\/jats:italic>\n                      for trend=0.01). Improved survival was attributable to both higher rates of prehospital survival, where risk-adjusted rates increased from 14.3% in 2005 to 2006 to 20.8% in 2012 (\n                      <jats:italic>P<\/jats:italic>\n                      for trend&lt;0.001), and in-hospital survival (\n                      <jats:italic>P<\/jats:italic>\n                      for trend=0.015). Rates of bystander cardiopulmonary resuscitation and automated external defibrillator use modestly increased during the study period and partly accounted for prehospital survival trends.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>Data drawn from a large subset of U.S communities suggest that rates of survival from out-of-hospital cardiac arrest have improved among sites participating in a performance improvement registry.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.114.009711","type":"journal-article","created":{"date-parts":[[2014,11,15]],"date-time":"2014-11-15T20:42:10Z","timestamp":1416084130000},"page":"1876-1882","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":515,"title":["Recent Trends in Survival From Out-of-Hospital Cardiac Arrest in the United States"],"prefix":"10.1161","volume":"130","author":[{"given":"Paul S.","family":"Chan","sequence":"first","affiliation":[{"name":"From Saint Luke\u2019s Mid America Heart Institute, Kansas City, MO (P.S.C., F.T.); the Department of Emergency Medicine, Emory University, and Rollins School of Public Health, Atlanta, GA (B.M.); and the Uniformed Services University of the Health Sciences, Bethesda, MD (A.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"McNally","sequence":"additional","affiliation":[{"name":"From Saint Luke\u2019s Mid America Heart Institute, Kansas City, MO (P.S.C., F.T.); the Department of Emergency Medicine, Emory University, and Rollins School of Public Health, Atlanta, GA (B.M.); and the Uniformed Services University of the Health Sciences, Bethesda, MD (A.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengming","family":"Tang","sequence":"additional","affiliation":[{"name":"From Saint Luke\u2019s Mid America Heart Institute, Kansas City, MO (P.S.C., F.T.); the Department of Emergency Medicine, Emory University, and Rollins School of Public Health, Atlanta, GA (B.M.); and the Uniformed Services University of the Health Sciences, Bethesda, MD (A.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Kellermann","sequence":"additional","affiliation":[{"name":"From Saint Luke\u2019s Mid America Heart Institute, Kansas City, MO (P.S.C., F.T.); the Department of Emergency Medicine, Emory University, and Rollins School of Public Health, Atlanta, GA (B.M.); and the Uniformed Services University of the Health Sciences, Bethesda, MD (A.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circoutcomes.109.889576"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012689"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa003289"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040566"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200010263431701"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000087403.24467.a4"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2010.01.036"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2009.03.018"},{"key":"e_1_3_4_10_2","first-page":"1","article-title":"Out-of-hospital cardiac arrest surveillance\u2014Cardiac Arrest Registry to Enhance Survival (CARES), United States, October 1, 2005\u2013December 31, 2010.","volume":"60","author":"McNally B","year":"2011","unstructured":"McNally B, Robb R, Mehta M, Vellano K, Valderrama AL, Yoon PW, Sasson C, Crouch A, Perez AB, Merritt R, Kellermann A; Centers for Disease Control and Prevention. Out-of-hospital cardiac arrest surveillance\u2014Cardiac Arrest Registry to Enhance Survival (CARES), United States, October 1, 2005\u2013December 31, 2010. MMWR Surveill Summ. 2011;60:1\u201319.","journal-title":"MMWR Surveill Summ"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000147236.85306.15"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(75)92830-5"},{"key":"e_1_3_4_13_2","volume-title":"Multilevel Statistical Models","author":"Goldstein H","year":"2003","unstructured":"Goldstein HMultilevel Statistical Models, 3rd Edition. London. Free 2nd Edition: http:\/\/www.ats.ucla.edu\/stat\/examples\/msm_goldstein\/goldstein.pdf: Arnold Publishers; 2003.","edition":"3"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2009.01.008"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh221"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.112.109496"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.734137"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.278483"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0908993"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.110.970913"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.971002"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.114.009711","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T02:58:53Z","timestamp":1715569133000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.114.009711"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,11,18]]},"references-count":21,"journal-issue":{"issue":"21","published-print":{"date-parts":[[2014,11,18]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.114.009711"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.114.009711","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.725237576.793527118","asserted-by":"object"}]},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,11,18]]},"assertion":[{"value":"2014-02-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-09-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-11-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}