| 1. |
- Andréassob, A-Ch, et al.
(författare)
-
Characteristics and outcome among patients with a suspected in hospital cardiac arrest
- 1998
-
Ingår i: Resuscitation. - : Elsevier Ireland Ltd. - 0300-9572 .- 1873-1570. ; 39:1-2, s. 23-31
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe the characteristics and outcome among patients with a suspected in-hospital cardiac arrest. METHODS: All the patients who suffered from a suspected in-hospital cardiac arrest during a 14-months period, where the cardiopulmonary resuscitation (CPR) team was called, were recorded and described prospectively in terms of characteristics and outcome. RESULTS: There were 278 calls for the CPR team. Of these, 216 suffered a true cardiac arrest, 16 a respiratory arrest and 46 neither. The percentage of patients who were discharged alive from hospital was 42% for cardiac arrest patients, 62% for respiratory arrest and 87% for the remaining patients. Among patients with a cardiac arrest, those found in ventricular fibrillation/ventricular tachycardia had a survival rate of 64%, those found in asystole 24% and those found in pulseless electrical activity 10%. Among patients who were being monitored at the time of arrest, the survival rate was 52%, as compared with 27% for non-monitored patients (P= 0.001). Among survivors of cardiac arrest, a cerebral performance category (CPC) of 1 (no major deficit) was observed in 81% at discharge and in 82% on admission to hospital prior to the arrest. CONCLUSION: We conclude that, during a 14-month period at Sahlgrenska University Hospital in Göteborg, almost half the patients with a cardiac arrest in which the CPR team was called were discharged from hospital. Among survivors, 81% had a CPC score of 1 at hospital discharge. Survival seems to be closely related to the relative effectiveness of the resuscitation organisation in different parts of the hospital.
|
|
| 2. |
- Herlitz, Johan, et al.
(författare)
-
Long-term prognosis among survivors after in-hospital cardiac arrest
- 2000
-
Ingår i: Resuscitation. - : Elsevier Ireland Ltd. - 0300-9572 .- 1873-1570. ; 45:3, s. 167-171
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe mortality and morbidity in the 2 years after discharge from hospital among patients surviving an in-hospital cardiac arrest. PATIENTS: All patients over a 2-year period who survived in-hospital cardiac arrest and could be discharged from hospital. SETTING: Sahlgrenska University Hospital in Göteborg. METHODS: The patients were followed prospectively for 2 years after discharge from hospital and evaluated in terms of mortality and morbidity and cerebral performance categories (CPC) score. CPC score was estimated by reference to the case notes. RESULTS: In all, 216 patients suffered in-hospital cardiac arrest and the resuscitation team was alerted: 79 patients (36.6%) were discharged alive. Among these 79 patients, 26.6% died, 7.8% developed a confirmed myocardial infarction and 1.3% developed a stroke during the subsequent 2 years. Among patients with a CPC score >1 at discharge (n=15), mortality was 66.7% as compared with 17.5% among patients with a CPC score of 1 (P=0.0008). Among patients aged >68 years (median) mortality was 39.5 versus 14.6% among patients < or =68 years of age (P=0.002). In all, 71% required rehospitalization for any reason and 51% required rehospitalization due to a cardiac cause. At hospital discharge 81% of all survivors had a CPC score of 1 and among survivors 2 years later 89% had a CPC score of 1. CONCLUSION: Among survivors of in-hospital arrest approximately 75% survived the subsequent 2 years. Survival was related to age and CPC score at discharge. Among survivors after 2 years the vast majority had a relatively good cerebral performance.
|
|
| 3. |
- Karlson, BW, et al.
(författare)
-
Improvement of ED prediction of cardiac mortality among patients with symptoms suggestive of acute myocardial infarction
- 1997
-
Ingår i: American Journal of Emergency Medicine. - : W.B. Saunders Co.. - 0735-6757 .- 1532-8171. ; 15:1, s. 1-7
-
Tidskriftsartikel (refereegranskat)abstract
- A study was undertaken to evaluate the 1-year risk of cardiac death for patients with chest pain/suspected acute myocardial infarction in the emergency department (ED) and express the prognosis in a statistical model. Clinical variables and electrocardiogram were correlated to cardiac death during 1 year. Cox regression model was used to estimate the risk of death as a continuous function of a risk score and the time interval. From these, the prognosis for each patient can be calculated. There were 6,794 visits by 5,303 patients followed for 1 year, during which 604 patients died. The absolute risk of cardiac death can be calculated from the independent predictors for cardiac death: age; sex; histories of diabetes mellitus, hypertension, and congestive heart failure; and symptoms, electrocardiographic pattern, and degree of suspicion of acute myocardial infarction on admission. This model allows estimation of the prognosis for every patient with chest pain/suspected acute myocardial infarction from data easily available in the ED.
|
|
| 4. |
- Rawshani, Araz, 1986, et al.
(författare)
-
Characteristics and outcome among patients who dial for the EMS due to chest pain
- 2014
-
Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 176:3, s. 859-865
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study aims to describe patients who called for the emergency medical service (EMS) due to chest discomfort, in relation to gender and age. Methods: All patients who called the emergency dispatch centre of western Sweden due to chest discomfort, between May 2009 and February 2010, were included. Initial evaluation, aetiology and outcome are described as recorded in the databases at the dispatch centre, the EMS systems and hospitals. Patients were divided into the following age groups: <= 50, 51-64 and >= 65 years. Results: In all, 14,454 cases were enrolled. Equal proportions of men (64%) and women (63%) were given dispatch priority 1. The EMS clinicians gave priority 1 more frequently to men (16% versus 12%) and older individuals (10%, 15% and 14%, respective of age group). Men had a significantly higher frequency of central chest pain (83% versus 81%); circulatory compromise (34% versus 31%); ECG signs of ischaemia (17% versus 11%); a preliminary diagnosis of acute coronary syndrome (40% versus 34%); a final diagnosis of acute myocardial infarction (14% versus 9%) and any potentially life-threatening condition (18% versus 12%). Individuals aged >= 65 years were given a lower priority than individuals aged 51-64 years, despite poorer characteristics and outcome. In all, 78% of cases with a potentially life-threatening condition and 67% of cases that died within 30 days of enrolment received dispatch priority 1. Mortality at one year was 1%, 4% and 18% in each individual age group. Conclusion: Men and the elderly were given a disproportionately low priority by the EMS. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
|
|
| 5. |
- Adielsson, A, et al.
(författare)
-
Increase in survival and bystander CPR in out-of-hospital shockable arrhythmia : bystander CPR and female gender are predictors of improved outcome. Experiences from Sweden in an 18-year perspective
- 2011
-
Ingår i: Heart. - : B M J Group. - 1355-6037 .- 1468-201X. ; 97:17, s. 1391-1396
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives In a national perspective, to describe survival among patients found in ventricular fibrillation or pulseless ventricular tachycardia witnessed by a bystander and with a presumed cardiac aetiology and answer two principal questions: (1) what are the changes over time? and (2) which are the factors of importance? Design Observational register study. Setting Sweden. Patients All patients included in the Swedish Out of Hospital Cardiac Arrest Register between 1 January 1990 and 31 December 2009 who were found in bystander-witnessed ventricular fibrillation with a presumed cardiac aetiology. Interventions Bystander cardiopulmonary resuscitation (CPR) and defibrillation. Main outcome measures Survival to 1 month. Results In all, 7187 patients fulfilled the set criteria. Age, place of out-of-hospital cardiac arrest (OHCA) and gender did not change. Bystander CPR increased from 46% to 73%; 95% CI for OR 1.060 to 1.081 per year. The median delay from collapse to defibrillation increased from 12 min to 14 min (p for trend 0.0004). Early survival increased from 28% to 45% (95% CI 1.044 to 1.065) and survival to 1 month increased from 12% to 23% (95% CI 1.058 to 1.086). Strong predictors of early and late survival were a short interval from collapse to defibrillation, bystander CPR, female gender and OHCA outside the home. Conclusion In a long-term perspective in Sweden, survival to 1 month after ventricular fibrillation almost doubled. This was associated with a marked increase in bystander CPR. Strong predictors of outcome were a short delay to defibrillation, bystander CPR, female gender and place of collapse.
|
|
| 6. |
- Bylow, H., et al.
(författare)
-
Learning Outcome After Different Combinations of Seven Learning Activities in Basic Life Support on Laypersons in Workplaces : a Cluster Randomised, Controlled Trial
- 2021
-
Ingår i: Medical Science Educator. - : Springer Science and Business Media LLC. - 2156-8650. ; 31:1, s. 161-173
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The goal for laypersons after training in basic life support (BLS) is to act effectively in an out-of-hospital cardiac arrest situation. However, it is still unclear whether BLS training targeting laypersons at workplaces is optimal or whether other effective learning activities are possible.Aim: The primary aim was to evaluate whether there were other modes of BLS training that improved learning outcome as compared with a control group, i.e. standard BLS training, six months after training, and secondarily directly after training.Methods: In this multi-arm trial, lay participants (n = 2623) from workplaces were cluster randomised into 16 different BLS interventions, of which one, instructor-led and film-based BLS training, was classified as control and standard, with which the other 15 were compared. The learning outcome was the total score for practical skills in BLS calculated using the modified Cardiff Test.Results: Four different training modes showed a significantly higher total score compared with standard (mean difference 2.3–2.9). The highest score was for the BLS intervention including a preparatory web-based education, instructor-led training, film-based instructions, reflective questions and a chest compression feedback device (95% CI for difference 0.9–5.0), 6 months after training.Conclusion: BLS training adding several different combinations of a preparatory web-based education, reflective questions and chest compression feedback to instructor-led training and film-based instructions obtained higher modified Cardiff Test total scores 6 months after training compared with standard BLS training alone. The differences were small in magnitude and the clinical relevance of our findings needs to be further explored.Trial Registration: ClinicalTrials.gov Identifier: NCT03618888. Registered August 07, 2018—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03618888 © 2020, The Author(s).
|
|
| 7. |
- Bång, A, et al.
(författare)
-
Evaluation of dispatcher assisted cardiopulmonary resuscitation
- 1999
-
Ingår i: European journal of emergency medicine. - : Lippincott Williams & Wilkins, Ltd.. - 0969-9546 .- 1473-5695. ; 6:3, s. 175-183
-
Tidskriftsartikel (refereegranskat)abstract
- The outcome of out-of-hospital cardiac arrest (CA) following cardiopulmonary resuscitation (CPR) initiated by dispatcher-provided telephone instructions (T-CPR) in the area of Gothenburg, Sweden was studied. During a period of 27 months, 475 cases categorized by the dispatchers at the Emergency Co-ordination and Dispatch Centre as being suspected CA were offered T-CPR and were included in one of the following groups: (1) T-CPR completed (caller without previous CPR training); (2) T-CPR completed (caller with previous CPR training); (3) T-CPR started, but not completed; (4) T-CPR declined by caller due to previous CPR training; (5) T-CPR declined by caller due to other reasons; or, (6) T-CPR not offered. Of the patients, 473 could be followed up and of them 427 fulfilled the criteria for CA on ambulance arrival. Among the latter cases, 10% were hospitalized alive, 4% could be discharged from hospital, and the distribution among groups was: (1) 7%; (2) 18%; (3) 5%; (4) 11%; (5) 3%; and (6) 1%. The study concludes that although more attention should be paid to the detection of CA patients by the dispatchers, when the dispatchers suspected CA, their accuracy was high. Half of the witnesses accepted the offer of T-CPR and one-third completed T-CPR. More efforts and research are needed, however, to increase the percentages of callers completing CPR. The impact of T-CPR on survival might be limited. Indeed, the comparison of 'resuscitable' patients in whom T-CPR played an important role in supporting bystanders (i.e. groups 1 and 2) with 'resuscitable' patients in whom T-CPR was not performed (i.e. groups 3, 5 and 6) suggests an increase in survival from 6% (groups 3, 5 and 6) to 9% (groups 1 and 2).
|
|
| 8. |
- Claesson, A, et al.
(författare)
-
Cardiac arrest due to drowning-changes over time and factors of importance for survival
- 2014
-
Ingår i: Resuscitation. - : Elsevier Ireland Ltd.. - 0300-9572 .- 1873-1570. ; 85:5, s. 644-648
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate changes in characteristics and survival over time in out-of-hospital cardiac arrest (OHCA) due to drowning and describe factors of importance for survival. METHOD: Retrospectively reported and treated drowning cases reported to the Swedish OHCA registry between 1990 and 2012, n=529. The data were clustered into three seven-year intervals for comparisons of changes over time. RESULTS: There were no changes in age, gender, witnessed status, shockable rhythm or place of OHCA during the time periods. Bystander CPR increased over time, 59% in interval 1992-1998, versus 74% in interval 2006-2012 (p=0.005). There was a decrease in delay between OHCA and calling for the Emergency Medical Service (EMS) over the years, while calling for the EMS to arrival increased in terms of time. Survival to hospital admission appears to have increased over the years (p=0.009), whereas survival to one month did not change significantly over time. In a multivariate analysis, witnessed status, female gender, bystander CPR, place-home and EMS response time were associated with survival to hospital admission. For survival to one month, place, age, shockable rhythm and logarithmised delay from calling for an ambulance to arrival were of significance for survival. CONCLUSION: In OHCA due to drowning, over a period of 20 years, bystanders have called for help at an earlier stage and administered CPR more frequently in the past few years. Survival to hospital admission has increased, while shockable rhythm and early arrival of the EMS appear to be the most important factors for survival to one month.
|
|
| 9. |
- Claesson, A, et al.
(författare)
-
Cardiac disease and probable intent after drowning
- 2013
-
Ingår i: American Journal of Emergency Medicine. - : W.B. Saunders Co.. - 0735-6757 .- 1532-8171. ; 31:7, s. 1073-7
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study is to determine the prevalence of cardiac disease and its relationship to the victim's probable intent among patients with cardiac arrest due to drowning. METHOD: Retrospective autopsied drowning cases reported to the Swedish National Board of Forensic Medicine between 1990 and 2010 were included, alongside reported and treated out-of-hospital cardiac arrests due to drowning from the Swedish Out of Hospital Cardiac Arrest Registry that matched events in the National Board of Forensic Medicine registry (n = 272). RESULTS: Of 2166 drowned victims, most (72%) were males; the median age was 58 years (interquartile range, 42-71 years). Drowning was determined to be accidental in 55%, suicidal in 28%, and murder in 0.5%, whereas the intent was unclear in 16%. A contributory cause of death was found in 21%, and cardiac disease as a possible contributor was found in 9% of all autopsy cases. Coronary artery sclerosis (5%) and myocardial infarction (2%) were most frequent. Overall, cardiac disease was found in 14% of all accidental drownings, as compared with no cases (0%) in the suicide group; P = .05. Ventricular fibrillation was found to be similar in both cardiac and noncardiac cases (7%). This arrhythmia was found in 6% of accidents and 11% of suicides (P = .23). CONCLUSION: Among 2166 autopsied cases of drowning, more than half were considered to be accidental, and less than one-third, suicidal. Among accidents, 14% were found to have a cardiac disease as a possible contributory factor; among suicides, the proportion was 0%. The low proportion of cases showing ventricular fibrillation was similar, regardless of the presence of a cardiac disease.
|
|
| 10. |
- Engdahl, J, et al.
(författare)
-
Can we define patients with no and those with some chance of survival when found in asystole out of hospital?
- 2000
-
Ingår i: American Journal of Cardiology. - : Excerpta Medica, Inc.. - 0002-9149 .- 1879-1913. ; 86:6, s. 610-614
-
Tidskriftsartikel (refereegranskat)abstract
- We describe the epidemiology, prognosis, and circumstances at resuscitation among a consecutive population of patients with out-of-hospital cardiac arrest (OHCA) with asystole as the arrhythmia first recorded by the Emergency Medical Service (EMS), and identify factors associated with survival. We included all patients in the municipality of Göteborg, regardless of age and etiology, who experienced an OHCA between 1981 and 1997. There were a total of 4,662 cardiac arrests attended by the EMS during the study period. Of these, 1,635 (35%) were judged as having asystole as the first-recorded arrhythmia: 156 of these patients (10%) were admitted alive to hospital, and 32 (2%) were discharged alive. Survivors were younger (median age 58 vs 68 years) and had a witnessed cardiac arrest more often than nonsurvivors (78% vs 50%). Survivors also had shorter intervals from collapse to arrival of ambulance (3.5 vs 6 minutes) and the mobile coronary care unit (MCCU) (5 vs 10 min), and they received atropine less often on scene. There were also a greater proportion of survivors with noncardiac etiologies of cardiac arrest (48% vs 27%). Survivors to discharge also displayed higher degrees of consciousness on arrival to the emergency department in comparison to nonsurvivors. Multivariate analysis among all patients with asystole indicated age (p = 0.01) and witnessed arrest (p = 0.03) as independent predictors of an increased chance of survival. Multivariate analysis among witnessed arrests indicated short time to arrival of the MCCU (p < 0.001) and no treatment with atropine (p = 0.05) as independent predictors of survival. Fifty-five percent of patients discharged alive had none or small neurologic deficits (cerebral performance categories 1 or 2). No patients > 70 years old with unwitnessed arrests (n = 211) survived to discharge.
|
|
