Chances of surviving a heart attack better in an airport or casino than in a U.S. hospital

Jan 7 2008

According to the latest research from the United States you have a better chance of surviving a heart attack if you have it in an airport or a casino, rather than a hospital.

It seems that all too often patients fail to receive life-saving defibrillation within the crucial two minutes when in hospital.

Those chances of surviving that heart attack are 50% in an airport or casino compared to 34% if your heart attack takes place at a U.S. hospital.

Researcher Paul Chan of the Mid-America Heart Institute in Kansas City, Missouri, who led the study says if defibrillation is given within two minutes at a hospital following a heart attack your chances of survival are about double, at 40%, compared to 22% if you don't.

Approximately three-quarters of a million people have a life-threatening alteration in heart rhythms in U.S. hospitals, while another 250,000 or so experience them outside hospitals.

There is a critical two-minute window for defibrillation for improving a patient's chances of survival after a heart attack.

The discrepancy occurs because generally people are on their own when in hospital while there are people milling about in airports and casinos who will respond immediately when a heart attack happens.

The study of 6,789 hospital patients found that defibrillation took more than two minutes in 30 percent of patients; their chance of surviving and leaving the hospital was 22 percent, compared to a rate of 39 percent for those who received shocks quickly.

The researchers from 369 hospitals in the National Registry of Cardiopulmonary Resuscitation say if the hospital is small, the risk of missing that window is even greater and the worst times in hospital for having a heart attack seem to be at night and during the weekend.

Another factor which could lower survival rates for people who have a heart attack in hospital is existing illness; a person who has a heart attack in a casino/airport is less likely to already have an underlying/existing illness, compared to a patient in a hospital who has a heart attack.

The research demonstrates that hospitals are failing to administer defibrillator shocks to patients who need them, and this could be costing many their lives.

The American Heart Association recommends that the stopped hearts be shocked within two minutes.

Dr. Paul Chan says systems of care must now be developed within the hospital setting to improve defibrillation times nationally. There are about 750,000 cardiac arrest cases in the U.S. annually and two-thirds occur in hospitals.

Dr. Chan led the study which is published in the New England Journal of Medicine (NEJM).