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- Hollenberg, Jacob, et al.
(författare)
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Difference in survival after out-of-hospital cardiac arrest between the two largest cities in Sweden: a matter of time?
- 2005
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Ingår i: J Intern Med. - : Wiley. - 0954-6820 .- 1365-2796. ; 257:3, s. 247-54
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Dramatic differences in survival after out-of-hospital cardiac arrests (OHCA) reported from different geographical locations require analysis. We therefore compared patients with OHCA in the two largest cities in Sweden with regard to various factors at resuscitation and outcome. SETTING: All patients suffering an OHCA in Stockholm and Goteborg between 1 January 2000 and 30 June 2001, in whom cardiopulmonary resuscitation (CPR) was attempted were included in this retrospective analysis. RESULTS: All together, 969 OHCA in Stockholm and 398 in Goteborg were registered during the 18-month study period. There were no differences in terms of age, gender, and percentage of witnessed cases or percentage of patients who had received bystander CPR. However, the percentage of patients with ventricular fibrillation (VF) at arrival of the ambulance crew was 18% in Stockholm versus 31% in Goteborg (P <0.0001). The percentage of patients who were alive 1 month after cardiac arrest was 2.5% in Stockholm versus 6.8% in Goteborg (P=0.0008). Various time intervals such as cardiac arrest to calling for an ambulance, cardiac arrest to the start of CPR and calling for an ambulance to its arrival were all significantly longer in Stockholm than in Goteborg. CONCLUSION: Survival was almost three times higher in Goteborg than in Stockholm amongst patients suffering an OHCA. This is primarily explained by a higher occurrence of VF at the time of arrival of the ambulance crew, which in turn probably is explained by shorter delays in Goteborg. The reason for the difference in time intervals is most likely multifactorial, with a significantly higher ambulance density in Goteborg as one possible explanation.
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| 2. |
- Hollenberg, Jacob, et al.
(författare)
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Improved survival after out-of-hospital cardiac arrest is associated with an increase in proportion of emergency crew--witnessed cases and bystander cardiopulmonary resuscitation.
- 2008
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Ingår i: Circulation. - : Lippincott Williams & Wilkins. - 1524-4539 .- 0009-7322. ; 118:4, s. 389-96
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is a major public health problem. We sought to describe changes in 1-month survival after OHCA in patients given cardiopulmonary resuscitation (CPR) during the last 14 years in Sweden. METHODS AND RESULTS: All patients experiencing OHCA in whom CPR was attempted between 1992 and 2005 and who were reported to the Swedish Cardiac Arrest Register were included in the study. In all, 38,646 patients were included in this survey. The proportion of patients who were admitted alive to a hospital increased from 15.3% in 1992 to 21.7% in 2005 (P for trend <0.0001). The corresponding values for patients being alive after 1 month were 4.8% and 7.3%, respectively (P for trend <0.0001). The increase in 1-month survival was particularly evident among patients found with a shockable rhythm (increase from 12.7% in 1992 to 22.3% in 2005; P for trend <0.0001). The corresponding figures for patients found with a nonshockable rhythm were 1.2% in 1992 and 2.3% in 2005 (P for trend=0.044). Factors that potentially contributed to the improved survival rate were an increase in emergency medical crew-witnessed cases from 9% in 1992 to 15% in 2005 (P for trend <0.0001) and, to a lesser degree, an increase in bystander CPR from 31% in 1992 to 50% in 2005 (P for trend <0.0001). After adjustment for potential risk factors, the increase in survival remained significant. CONCLUSIONS: We found a significant increase in survival after OHCA in Sweden over the last 14 years. The increase was particularly marked among patients found with a shockable rhythm and was associated with an increase in the proportion of crew-witnessed cases and, to a lesser degree, an increase in the performance of bystander CPR.
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