{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T01:13:51Z","timestamp":1790385231936,"version":"4.1.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Although current guidelines recommend implantable cardioverter\u2010defibrillator (ICD) placement in survivors of out\u2010of\u2010hospital cardiac arrest, contemporary data on secondary\u2010prevention ICDs in survivors of out\u2010of\u2010hospital cardiac arrest remain limited.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Using 2013 to 2019 CARES (Cardiac Arrest Registry to Enhance Survival) linked to Medicare, we identified 3226 patients aged \u226565\u2009years with an initial shockable rhythm who survived to discharge without severe neurological disability. Multivariable hierarchical regression models were used to examine the association between patient variables and ICD placement and quantify hospital variation in ICD implantation. The mean age was 72.2\u2009years, 23.5% were women, 10% were Black individuals, and 4% were Hispanic individuals. Overall, 997 (30.9%) patients received an ICD before discharge, 1266 (39.2%) at 90\u2009days, and 1287 (39.9%) within 6\u2009months. Older age (\u226585\u2009years), female sex, history of diabetes, calendar year, and presentation with acute myocardial infarction were associated with lower odds of ICD implantation, but race or ethnicity was not associated with ICD implantation. Among 297 hospitals, the median proportion of survivors receiving ICD at discharge was 28.6% (interquartile range, 20%\u201350%). The relative odds of ICD implantation varied by 62% across hospitals (median odds ratio, 1.62 [95% CI, 1.38\u20131.82]) after adjusting for case mix.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Fewer than 1 in 3 survivors of out\u2010of\u2010hospital cardiac arrest due to a shockable rhythm received a secondary\u2010prevention ICD before discharge. Although patient variables were associated with ICD implantation, there was no difference by race or ethnicity. Even after adjusting for patient case mix, ICD implantation varied markedly across hospitals.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.036123","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T09:28:06Z","timestamp":1726651686000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Implantable Cardioverter\u2010Defibrillators Among Older Survivors of Out\u2010of\u2010Hospital Cardiac Arrest"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6821-0045","authenticated-orcid":false,"given":"Mason","family":"Marcus","sequence":"first","affiliation":[{"name":"University of Texas\u2010Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5185-3367","authenticated-orcid":false,"given":"Paul S.","family":"Chan","sequence":"additional","affiliation":[{"name":"Saint Luke\u2019s Mid America Heart Institute and the University of Missouri\u2010Kansas City MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2981-6030","authenticated-orcid":false,"given":"Anping","family":"Chang","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7688-8112","authenticated-orcid":false,"given":"Robert K.","family":"Merritt","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3532-1931","authenticated-orcid":false,"given":"Bryan","family":"McNally","sequence":"additional","affiliation":[{"name":"Emory University Rollins School of Public Health Atlanta GA USA"},{"name":"Department of Emergency Medicine Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5277-9296","authenticated-orcid":false,"given":"Mark S.","family":"Link","sequence":"additional","affiliation":[{"name":"University of Texas\u2010Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4784-4513","authenticated-orcid":false,"given":"Saket","family":"Girotra","sequence":"additional","affiliation":[{"name":"University of Texas\u2010Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000548"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2000.2476"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199711273372202"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00253-5"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2017.05.013"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2009.02509.x"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.05.053"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.01.030"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.122.009042"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.018175"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2009.03.018"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.84.2.960"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(75)92830-5"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_3_1_16_2","volume-title":"Multilevel Statistical Models","author":"Goldstein H","year":"1995","unstructured":"Goldstein H. 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