| 1. |
- Claesson, Andreas, et al.
(författare)
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Defibrillation before EMS arrival in western Sweden
- 2017
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Ingår i: American Journal of Emergency Medicine. - : Elsevier. - 0735-6757 .- 1532-8171. ; 35:8, s. 1043-1048
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Bystanders play a vital role in public access defibrillation (PAD) in out-of-hospital cardiac arrest (OHCA). Dual dispatch of first responders (FR) alongside emergency medical services (EMS) can reduce time to first defibrillation. The aim of this study was to describe the use of automated external defibrillators (AEDs) in OHCAs before EMS arrival.METHODS: All OHCA cases with a shockable rhythm in which an AED was used prior to the arrival of EMS between 2008 and 2015 in western Sweden were eligible for inclusion. Data from the Swedish Register for Cardiopulmonary Resuscitation (SRCR) were used for analysis, on-site bystander and FR defibrillation were compared with EMS defibrillation in the final analysis.RESULTS: Of the reported 6675 cases, 24% suffered ventricular fibrillation (VF), 162 patients (15%) of all VF cases were defibrillated before EMS arrival, 46% with a public AED on site. The proportion of cases defibrillated before EMS arrival increased from 5% in 2008 to 20% in 2015 (p<0.001). During this period, 30-day survival increased in patients with VF from 22% to 28% (p=0.04) and was highest when an AED was used on site (68%), with a median delay of 6.5min from collapse to defibrillation. Adjusted odds ratio for on-site defibrillation versus dispatched defibrillation for 30-day survival was 2.45 (95% CI: 1.02-5.95).CONCLUSIONS: The use of AEDs before the arrival of EMS increased over time. This was associated with an increased 30-day survival among patients with VF. Thirty-day survival was highest when an AED was used on site before EMS arrival.
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| 2. |
- Bruze, Gustaf, et al.
(författare)
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Hospital admission after gastric bypass : a nationwide cohort study with up to 6 years follow-up.
- 2017
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Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier. - 1550-7289 .- 1878-7533. ; 13:6, s. 962-969
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Several studies have addressed short-term admission rates after bariatric surgery. However, studies on long-term admission rates are few and population based studies are even scarcer.OBJECTIVE: The aim of this study was to assess short- and long-term admission rates for gastrointestinal surgery after gastric bypass in Sweden compared with admission rates in the general population.SETTING: Swedish healthcare system.METHODS: The surgery cohort consisted of adults with body mass index≥35 identified in the Scandinavian Obesity Surgery Registry (n = 28,331; mean age 41 years; 76% women; Roux-en-Y gastric bypass performed 2007-2012). For each individual, up to 10 comparators from the general population were matched on birth year, sex, and place of residence (n = 274,513). The primary outcome was inpatient admissions due to gastrointestinal surgery retrieved from the National Patient Register through December 31, 2014. Conditional hazard ratios (HR) were estimated using Cox regression.RESULTS: All-cause admission rates were 6.5%, 21.4%, and 65.9% during 30 days, 1 year, and 6 years after surgery, respectively. The corresponding rates for gastrointestinal surgery were 1.8%, 6.8%, and 24.4%. Compared with that of the general population, there was an increased risk of all-cause hospital admission at 1 year (HR 2.6 [2.5-2.6]) and 6 years (HR 2.7 [2.6-2.7]). The risk of hospital admission for any gastrointestinal surgical procedure was greatly increased throughout the study period (HR 8.6 [8.4-8.9]). Female sex, psychiatric disease, and low education were risk factors.CONCLUSION: We found a significant risk of admission to hospital over>6 years after gastric bypass surgery.
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| 3. |
- Droeser, R. A., et al.
(författare)
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Hypoparathyroidism after total thyroidectomy in patients with previous gastric bypass
- 2017
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Ingår i: Langenbecks Archives of Surgery. - : Springer Science and Business Media LLC. - 1435-2443 .- 1435-2451. ; 402:2, s. 273-280
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Case reports suggest that patients with previous gastric bypass have an increased risk of severe hypocalcemia after total thyroidectomy, but there are no population-based studies. The prevalence of gastric bypass before thyroidectomy and the risk of hypocalcemia after thyroidectomy in patients with previous gastric bypass were investigated. Methods By cross-linking The Scandinavian Quality Registry for Thyroid, Parathyroid and Adrenal Surgery with the Scandinavian Obesity Surgery Registry patients operated with total thyroidectomy without concurrent or previous surgery for hyperparathyroidism were identified and grouped according to previous gastric bypass. The risk of treatment with intravenous calcium during hospital stay, and with oral calcium and vitamin D at 6 weeks and 6 months postoperatively was calculated by using multiple logistic regression in the overall cohort and in a 1:1 nested case-control analysis. Results We identified 6115 patients treated with total thyroidectomy. Out of these, 25 (0.4 %) had undergone previous gastric bypass surgery. In logistic regression, previous gastric bypass was not associated with treatment with i.v. calcium (OR 2.05, 95 % CI 0.48-8.74), or calcium and/or vitamin D at 6 weeks (1.14 (0.39-3.35), 1.31 (0.39-4.42)) or 6 months after total thyroidectomy (1.71 (0.40-7.32), 2.28 (0.53-9.75)). In the nested case-control analysis, rates of treatment for hypocalcemia were similar in patients with and without previous gastric bypass. Conclusion Previous gastric bypass surgery was infrequent in patients undergoing total thyroidectomy and was not associated with an increased risk of postoperative hypocalcemia.
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