Assumptions Discredit ALS vs. BLS Study

THE RESEARCH Sanghavi P, Jena AB, Newhouse JP, et al. Outcomes after out-of-hospital cardiac arrest treated by basic vs advanced life support. JAMA Intern Med. 2015;175(2):196–204. THE SCIENCE The authors undertook a comparison of BLS vs. ALS care on the outcome of cardiac arrest by examining a representative sample of Medicare beneficiaries from non-rural counties in the United States who had “cardiac arrest” as their hospital admission diagnosis between 2009 and 2011. They made the assumption an EMS agency that billed Medicare at the BLS rate delivered BLS care and billed ALS rates for ALS care. They linked the EMS cases to their respective hospital admission and examined their outcomes. Cardiac arrest victims cared for with BLS had a greater likelihood of surviving to hospital discharge as compared to ALS (13.1% vs 9.2%, respectively). Survival to 90 days post-discharge was also higher than ALS (8.0% vs 5.4%). And not surprising, BLS patients had better neurological function than ALS (79.2% vs 55.7%). Authors also examined the medical expenditures on the Medicare patients throughout the year following their cardiac arrest. They concluded, “Patients with out-of-hospital cardiac arrest who received BLS had higher survival at hospital discharge and at 90 days compared with those who received ALS and were less likely to experience poor neurological functioning.” In their discussion portion of the paper the authors further state: “Our estimates suggest that each yea...
Source: JEMS Special Topics - Category: Emergency Medicine Authors: Tags: Columns Cardiac & Resuscitation Special Topics Patient Care Source Type: news