Emergency department factors associated with survival after sudden cardiac arrest

Resuscitation ◽  
2013 ◽  
Vol 84 (3) ◽  
pp. 292-297 ◽  
Author(s):  
Nicholas J. Johnson ◽  
Rama A. Salhi ◽  
Benjamin S. Abella ◽  
Robert W. Neumar ◽  
David F. Gaieski ◽  
...  
2011 ◽  
Vol 79 (2) ◽  
pp. 218-227 ◽  
Author(s):  
Patrick H. Pun ◽  
Ruediger W. Lehrich ◽  
Emily F. Honeycutt ◽  
Charles A. Herzog ◽  
John P. Middleton

Resuscitation ◽  
2014 ◽  
Vol 85 ◽  
pp. S22
Author(s):  
Fernando Rosell-Ortiz ◽  
Francisco Mellado-Vergel ◽  
Patricia Fernández del Valle ◽  
Ismael González-Lobato ◽  
María M. Ruiz-Montero ◽  
...  

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Melody Hermel ◽  
Nichole Bosson ◽  
Andrea Fang ◽  
William J. French ◽  
James T. Niemann ◽  
...  

Background Despite the benefits of targeted temperature management (TTM) for out‐of‐hospital cardiac arrest), implementation within the United States remains low. The objective of this study was to evaluate the prevalence and factors associated with TTM use in a large, urban‐suburban regional system of care. Methods and Results This was a retrospective analysis from the Los Angeles County regional cardiac system of care serving a population of >10 million residents. All adult patients aged ≥18 years with non‐traumatic out‐of‐hospital cardiac arrest transported to a cardiac arrest center from April 2011 to August 2017 were included. Patients awake and alert in the emergency department and patients who died in the emergency department before consideration for TTM were excluded. The primary outcome measure was prevalence of TTM use. The secondary analysis were annual trends in TTM use over the study period and factors associated with TTM use. The study population included 8072 patients; 4154 patients (51.5%) received TTM and 3767 patients (46.7%) did not receive TTM. Median age was 67 years, 4780 patients (59.2%) were men, 4645 patients (57.5%) were non‐White, and the most common arrest location was personal residence in 4841 patients (60.0%). In the adjusted analysis, younger age, male sex, an initial shockable rhythm, witnessed arrest, and receiving coronary angiography were associated with receiving TTM. Conclusions Within this regional system of care, use of TTM was higher than previously reported in the literature at just over 50%. Use of integrated systems of care may be a novel method to increase TTM use within the United States.


1988 ◽  
Vol 6 (4) ◽  
pp. 319-323 ◽  
Author(s):  
Mickey S. Eisenberg ◽  
Eli Hadas ◽  
Irit Nuri ◽  
David Applebaum ◽  
Arie Roth ◽  
...  

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
N Carlsson ◽  
K Arestedt ◽  
A Alvariza ◽  
L Axelsson ◽  
A Bremer

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Linnaeus University, Sweden Background High incidence and mortality make cardiac arrest one of the leading causes of death in western countries. Death from sudden cardiac arrest implies a stressful and challenging situation for bereaved family members with increased risk for prolonged grief disorder. This serious disorder needs to be identified and treated. Purpose To explore factors associated with symptoms of prolonged grief among bereaved family members of persons who died from sudden cardiac arrest. Methods This cross-sectional observational study was based on a questionnaire to bereaved family members six month after the death. Background questions about the family member and the loss, the Prolonged Grief disorder instrument (PG-13) and the Multidimensional Scale of Perceived Social Support (MSPSS) were included and analyzed using univariate and multiple linear regression. Results This study included 108 family members who were adult children (n = 55, 51%), spouse (n = 36, 33%), or significant others (n = 17, 16%) to a person that died of sudden cardiac arrest. The mean age of the family members was 61 years (range 25-87), most were women (n = 74, 69%), and did not have a university degree (n = 74, 69%). A majority of the cardiac arrests took place out of hospital (n = 59, 81%). One third of the family members were present during the resuscitation (n = 35, 32%). A minority was offered professional support from the healthcare service (n = 93, 86%) and few sought healthcare for problems in relation to the loss (n = 19, 18%) and/or received professional support from a psychologist or equivalent (n = 16, 15%). In total, 18% (n = 19) reported symptoms of prolonged grief and the prevalence was even higher among spouses (n = 10, 29%). In the univariate regression models, being a spouse of the deceased (B = 6.34, p = 0.004, R2 = 0.08), sought healthcare related to the loss (B = 10.51, p < 0.001, R2 = 0.15), offered support from the healthcare related to the loss (B = 6.28, p = 0.030, R2 = 0.05), received professional support for the loss (B = 7.30, p = 0.011, R2 = 0.06), and lower levels of perceived social support (B=-0.28, p < 0.001, R2 = 0.16) were significantly associated with higher levels of symptoms of prolonged grief. All these variables, except offered support from the healthcare, were still significant in the multiple regression model and explained 35% of the total variance in PG-13 (F(4, 96)=12.96, p < 0.001). Age, sex, education, and presence during resuscitation were not significantly associated with symptoms of prolonged grief in any of the regression models. Conclusion Prolonged grief is a significant problem in bereaved family members of persons who died from sudden cardiac arrest, particularly in spouses, those in need of professional support from the healthcare, and those with low social support. Bereavement support should be offered to reduce the risk to developing prolonged grief after unsuccessful resuscitation and sudden death from cardiac arrest.


Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Jooyeong Kim ◽  
Kim Sung Jin ◽  
Jonghak Park ◽  
Sejoong Ahn ◽  
Juhyun Song ◽  
...  

Introduction: Electrolyte disturbances are associated with sudden cardiac arrest based on several cohort studies. However little is known about the association between serum magnesium(S-Mg) level at ED arrival and survival of out-of-hospital cardiac arrest (OHCA) patients. Hypothesis: We hypothesized S-Mg level at ED arrival is associated with favorable neurologic outcome of OHCA patients. Methods: This is an observational study using Korean Cardiac Arrest Research Consortium (KoCARC) data from October 2015 to June 2020. EMS treated OHCA patients over 18 years old who survived to ICU admission were included. Those without S-Mg level were excluded. Exposure is S-Mg level at emergency department (ED) arrival and outcome was favorable neurologic outcome (cerebral performance category 1 or 2) at hospital discharge. S-Mg was categorized into three groups; Low group; 0-1.7mg/dl, Normal group;1.7-2.3mg/dl, High group; over 2.3mg/dl). Multivariable logistic regression was performed to calculate adjusted odds ratios (AORs) with 95% confidence intervals (95% CIs) for outcome. Results: From total 10,897 OHCA patients, 2,789 patients survived to ICU admission and 1,370 patients had initial S-Mg result. Favorable neurologic outcome was 27.4% in low group, 55.7% in normal group and 23.0% in high group. After adjusting potential confounders in multivariable logistic analysis, compared to the normal group, AOR was 0.28 (95% CI 0.11-0.75) at low group and 0.43 (95% CI 0.23-0.82) at high group. Conclusion: Low (S-Mg less than 1.7 mg/dl) or high (S-Mg over 2.3mg/dl) S-Mg level measured initially at ED arrival for OHCA patients was associated with worse neurologic outcome compared to normal S-Mg level (S-Mg 1.7-2.3mg/dl). Based on this study, further study is needed to investigate the optimized S-Mg level for OHCA patient under resuscitation.


2015 ◽  
Vol 133 (6) ◽  
pp. 495-501 ◽  
Author(s):  
Cássia Regina Vancini-Campanharo ◽  
Rodrigo Luiz Vancini ◽  
Claudio Andre Barbosa de Lira ◽  
Marília dos Santos Andrade ◽  
Aécio Flávio Teixeira de Góis ◽  
...  

CONTEXT AND OBJECTIVE: Cardiac arrest is a common occurrence, and even with efficient emergency treatment, it is associated with a poor prognosis. Identification of predictors of survival after cardiopulmonary resuscitation may provide important information for the healthcare team and family. The aim of this study was to identify factors associated with the survival of patients treated for cardiac arrest, after a one-year follow-up period. DESIGN AND SETTING: Prospective cohort study conducted in the emergency department of a Brazilian university hospital. METHODS: The inclusion criterion was that the patients presented cardiac arrest that was treated in the emergency department (n = 285). Data were collected using the In-hospital Utstein Style template. Cox regression was used to determine which variables were associated with the survival rate (with 95% significance level). RESULTS: After one year, the survival rate was low. Among the patients treated, 39.6% experienced a return of spontaneous circulation; 18.6% survived for 24 hours and of these, 5.6% were discharged and 4.5% were alive after one year of follow-up. Patients with pulseless electrical activity were half as likely to survive as patients with ventricular fibrillation. For patients with asystole, the survival rate was 3.5 times lower than that of patients with pulseless electrical activity. CONCLUSIONS: The initial cardiac rhythm was the best predictor of patient survival. Compared with ventricular fibrillation, pulseless electrical activity was associated with shorter survival times. In turn, compared with pulseless electrical activity, asystole was associated with an even lower survival rate.


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