| 1. |
- Axelsson, Christer, et al.
(författare)
-
PCI De Lucs. : A clinical pathway directly to the PCI lab in out of hospital cardiac arrest
- 2016
-
Ingår i: American Heart Association.
-
Konferensbidrag (refereegranskat)abstract
- Purpose: In Sweden, the ambulance response time from call to arrival is 11 minutes in patients with an out-of-hospital cardiac arrest (OHCA). However, there is a small group of OHCA patients (20%) in whom this delay is minimized, namely those that occur minutes before or after the arrival of the ambulance. Despite CPR and/or defibrillation within one minute, only 20% survive to hospital discharge. The objective was therefore to determine whether a pathway with direct transportation to the cath lab, using mechanical chest compression (LUCAS), could improve survival in this selected group.Aim: To describe characteristics, feasibility and outcome among a selected group of OHCA patients transported directly to the cath lab by the ambulance in a new pathwayMethod: A prospective observational study from November 2013 to November 2015Inclusion criteria: 1. Crew-witnessed cardiac arrest (CA) of cardiac origin or CA immediately defibrillated to return of spontaneous circulation (ROSC) by public access. 2. CA occurring two to three minutes before ambulance arrival where the patient had immediate bystander CPR of high quality. 4. CA occurring two to three minutes before ambulance arrival where the patient was still breathing at ambulance arrival.Exclusion criteria: Non-cardiac origin CA or high physiologic age (hospice patients)Result: Sixty-four patients fulfilled the inclusion criteria and 14 were excluded. Of the remaining 50 patients, 25 were transported with mechanical CPR to the cath lab. The time from CA to hospital was a median of 38 minutes. Survival to 30 days was 38% among all patients, 47% among VF (N=34) and 12% (N=25) among those who were transported with mechanical CPR.Conclusion: The pathway appears safe and feasible, but the inclusion criteria need to be less complex. The vast majority of survivors were found in the VF population. There were survivors (12%) among patients transported with ongoing CPR (N=25) directly to the cath lab by the ambulance.
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
- Bäck, Maria, 1978, et al.
(författare)
-
How does kinesiophobia change over time in patients with acute coronary artery disease?
- 2015
-
Ingår i: Physiotherapy, Oral presentation, World Confederation for Physical Therapy (WCPT), 1-4 May 2015Singapore. - : Elsevier BV. ; 101:Suppl. 1
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The occurrence of kinesiophobia and the impact on kinesiophobia by clinical variables with influence on rehabilitation outcomes in exercise-based cardiac rehabilitation (CR) has by us been identified six months after acute coronary artery disease (CAD). However, the occurrence of kinesiophobia in the acute phase of CAD and how it changes over time has not previously been studied. Moreover, the gender perspective has not been highlighted. The primary purpose was to identify levels of kinesiophobia in the acute phase of CAD and to study changes over time and in relation to gender. Participants: In total, 105 patients with CAD (25 women), mean age 63.1±11.5 were included in the study at the cardiac intensive care, Sahlgrenska University Hospital, Sweden between October 2013 and June 2014. Design and statistics: The patients were asked to fill in a set of questionnaires including the Tampascale for Kinesiophobia Heart (TSK-SV Heart), the Hospital Anxiety and Depression Scale (HADS), Harm Avoidance (HA) and the Positive and Negative Affect Schedule (PANAS). The patients filled in the questionnaires at three different time points: At the cardiac intensive care (T1), after 2 weeks (T2) and after 4 months (T3). A linear mixed model (LMM) procedure was used to compare kinesiophobia across time points. The within-subjects-design factor was data collection time (T1-T3), and the between-subjects-design factor was gender. The dependent variable was kinesiophobia. The questionnaires reflecting personality traits and affective states (HADS, PANAS, HA) were used as covariates in order to discover any effects these might have on differences across groupings. Covariates were included in two steps: first all five, then only those that contributed significantly at p-level < 0.05. Thirty-five patients were excluded due to loss of follow-up or missing data. The mean value on the TSK-SV Heart was 32.1 at T1, 30.3 at T2 and 29.2 at T3. The presence of a high level of kinesiophobia was 24% at T1 and 19% at T2 and T3. Without covariates, there was an effect of gender (p=0.011), with a higher TSK-SV Heart mean score for women, and over time points (p=0.013), with lower TSK-SV Heart mean score at T3. No interaction effect was found. Inclusion of the covariates showed that the HADS variables had no impact on kinesiophobia. Although negative affect (p=0.016), positive affect (p=0.002), and HA (p=0.057) had impact on kinesiophobia, this did not influence the significane of gender (p=0.042) and over time points (p=0.004). Kinesiophobia decreased over time after acute CAD, independent of patients´ personality traits and affective states. Female gender had a significant influence on kinesiohobia. Still 19% of the patients were identified with a high level of kinesiophobia at T3. The further establishment of the impact of kinesiophobia in CR and the design of a treatment intervention should be prioritized in future studies. The results of this study suggest that it is desirable to screen for kinesiophobia in the acute phase of CAD, as recognition may facilitate the appropriate treatment for these patients with the overall target of enhancing attendance at CR.
|
|
| 10. |
- Bäck, Maria, 1978, et al.
(författare)
-
Kinesiofobi (rörelserädsla) hos patienter med kranskärlssjukdom
- 2011
-
Ingår i: Abstraktbok Sjukgymnastdagarna 14-16 sept 2011, Stockholm.
-
Konferensbidrag (refereegranskat)abstract
- Bakgrund och syfte Att patienter med kranskärlssjukdom är rörelserädda är ett känt kliniskt fenomen, som dock inte finns vetenskapligt studerat. Studiens syfte var tvådelat: 1). Reliabilitets- och validitetstesta Tampaskalan för kinesiofobi – Heart (TSK-SV Heart). 2). Undersöka förekomsten av kinesiofobi bland patienter med kranskärlssjukdom. Metoder Studien bestod av 332 patienter (75 kvinnor) med kranskärlssjukdom som vårdats vid Sahlgrenska Universitetssjukhuset/Sahlgrenska mellan 2007-2009. Patienterna inkluderades 6 månader efter vårdtillfället. Kinesiofobi utvärderades med TSK-SV Heart, ett frågeformulär som subjektivt mäter patientens grad av kinesiofobi. Ett värde >37 poäng indikerar kinesiofobi. För test av reliabilitet av TSK-SV Heart mättes stabilitet över tid, inre konsistens samt homogenitet. Validitetstesterna inkluderade ytvaliditet, innehållsvaliditet samt begreppsvaliditet. Resultat Reliabilitetstesterna visade på en god stabilitet över tid (Intraclass Correlation Coefficient=0.84) och en god inre konsistens (Cronbach’s alpha=0.79). Validitetstesterna resulterade i en god yt- och innehållsvaliditet. Begreppsvaliditeten utvärderades genom en konfirmatorisk faktoranalys som visade på acceptabla modellanpassningmått för en fyra faktor modell. Tjugo procent av patienterna hade en förhöjd grad av kinesiofobi (>37 poäng på TSK-SV Heart). Konklusion Att med ett reliabelt och valitt instrument kunna identifiera de patienter med kranskärlssjukdom som har en hög grad av kinesiofobi kan vara ett första steg mot att utforma en behandling för att öka dessa patienters följsamhet till fysisk aktivitet och träning, som har väl vedertagna positiva effekter.
|
|
