Correlation Between EMS Agency Rates of Survival to Hospital Admission and Hospital Survival Outcomes for Cardiac Arrest.

EMS agency risk-standardized survival to hospital admission for adults with nontraumatic out-of-hospital cardiac arrest is strongly correlated with survival to discharge (weighted r=0.68) and favorable neurological survival (weighted r=0.54) in 2015–2019.

• Why it matters: Admission survival is used to gauge EMS performance, but its relationship to downstream hospital discharge and neurological outcomes was unclear, limiting confidence in this metric.
• What they did: Using CARES data, adults from 1838 EMS agencies were analyzed in 2015–2019 and 2022–2024 with multivariable hierarchical logistic regression to compute agency-level risk-standardized rates, then weighted linear regression to estimate correlations.
• The result: Correlations remained strong after the pandemic peak (survival to discharge weighted r=0.63; favorable neurological survival weighted r=0.48), and neighborhood income and racial/ethnic composition modified admission–discharge correlations (all interactions <0.05) while staying strong within each group.