scholarly journals Treatment and survival following in-hospital cardiac arrest: does patient ethnicity matter?

2021 ◽  
Author(s):  
Jens Agerström ◽  
Magnus Carlsson ◽  
Anders Bremer ◽  
Johan Herlitz ◽  
Araz Rawshani ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Middle Eastern ◽  
Ethnic Disparities ◽  
Great Majority ◽  
Heart Rhythm ◽  
Hospital Staff ◽  
Registry Study ◽  
The Impact ◽  
Hospital Cardiac Arrest

Abstract Aims  Previous research on racial/ethnic disparities in relation to cardiac arrest has mainly focused on black vs. white disparities in the USA. The great majority of these studies concerns out-of-hospital cardiac arrest (OHCA). The current nationwide registry study aims to explore whether there are ethnic differences in treatment and survival following in-hospital cardiac arrest (IHCA), examining possible disparities towards Middle Eastern and African minorities in a European context. Methods and results In this retrospective registry study, 24 217 patients from the IHCA part of the Swedish Registry of Cardiopulmonary Resuscitation were included. Data on patient ethnicity were obtained from Statistics Sweden. Regression analysis was performed to assess the impact of ethnicity on cardiopulmonary resuscitation (CPR) delay, CPR duration, survival immediately after CPR, and the medical team’s reported satisfaction with the treatment. Middle Eastern and African patients were not treated significantly different compared to Nordic patients when controlling for hospital, year, age, sex, socioeconomic status, comorbidity, aetiology, and initial heart rhythm. Interestingly, we find that Middle Eastern patients were more likely to survive than Nordic patients (odds ratio = 1.52). Conclusion Overall, hospital staff do not appear to treat IHCA patients differently based on their ethnicity. Nevertheless, Middle Eastern patients are more likely to survive IHCA.

scholarly journals What Do Adolescents Learn from a 50 Minute Cardiopulmonary Resuscitation/Automated External Defibrillator Education in a Rural Area: A Pre-Post Design

2019 ◽  
Vol 16 (6) ◽  
pp. 1053
Author(s):  
Ming-Fen Tsai ◽  
Li-Hsiang Wang ◽  
Ming-Shyan Lin ◽  
Mei-Yen Chen
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Education Program ◽  
Individual Performance ◽  
Automated External Defibrillator ◽  
Quasi Experimental ◽  
Rescue Time ◽  
The Impact ◽  
Hospital Cardiac Arrest ◽  
External Defibrillator

Background: Literature indicates that patients who receive cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) from bystanders have a greater chance of surviving out-of-hospital cardiac arrest (OHCA). A few evaluative studies involving CPR/AED education programs for rural adolescents have been initiated. This study aimed to examine the impact of a 50 min education program that combined CPR with AED training in two rural campuses. Methods: A quasi-experimental pre-post design was used. The 50 min CPR/AED training and individual performance using a Resusci Anne manikin was implemented with seventh grade students between August and December 2018. Results: A total of 336 participants were included in this study. The findings indicated that the 50 min CPR/AED education program significantly improved participant knowledge of emergency responses (p < 0.001), correct actions at home (p < 0.01) and outside (p < 0.001) during an emergency, and willingness to perform CPR if necessary (p < 0.001). Many participants described that “I felt more confident to perform CPR/AED,” and that “It reduces my anxiety and saves the valuable rescue time.” Conclusions: The brief education program significantly improved the immediate knowledge of cardiac emergency in participants and empowered them to act as first responders when they witnessed someone experiencing a cardiac arrest. Further studies should consider the study design and explore the effectiveness of such brief programs.

Impact of Dispatcher-Assisted Bystander Cardiopulmonary Resuscitation with Out-of-Hospital Cardiac Arrest: A Systemic Review and Meta-Analysis

2020 ◽  
Vol 35 (4) ◽  
pp. 372-381
Author(s):  
Junhong Wang ◽  
Hua Zhang ◽  
Zongxuan Zhao ◽  
Kaifeng Wen ◽  
Yaoke Xu ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Meta Analysis ◽  
Systemic Review ◽  
Cochrane Library ◽  
Significant Difference ◽  
Bystander Cardiopulmonary Resuscitation ◽  
The Impact ◽  
Hospital Cardiac Arrest

AbstractObjective:This systemic review and meta-analysis was conducted to explore the impact of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) on bystander cardiopulmonary resuscitation (BCPR) probability, survival, and neurological outcomes with out-of-hospital cardiac arrest (OHCA).Methods:Electronically searching of PubMed, Embase, and Cochrane Library, along with manual retrieval, were done for clinical trials about the impact of DA-BCPR which were published from the date of inception to December 2018. The literature was screened according to inclusion and exclusion criteria, the baseline information, and interested outcomes were extracted. Two reviewers assessed the methodological quality of the included studies. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated by STATA version 13.1.Results:In 13 studies, 235,550 patients were enrolled. Compared with no dispatcher instruction, DA-BCPR tended to be effective in improving BCPR rate (I2 = 98.2%; OR = 5.84; 95% CI, 4.58-7.46; P <.01), return of spontaneous circulation (ROSC) before admission (I2 = 36.0%; OR = 1.17; 95% CI, 1.06-1.29; P <.01), discharge or 30-day survival rate (I2 = 47.7%; OR = 1.25; 95% CI, 1.06-1.46; P <.01), and good neurological outcome (I2 = 30.9%; OR = 1.24; 95% CI, 1.04-1.48; P = .01). However, no significant difference in hospital admission was found (I2 = 29.0%; OR = 1.09; 95% CI, 0.91-1.30; P = .36).Conclusion:This review shows DA-BPCR plays a positive role for OHCA as a critical section in the life chain. It is effective in improving the probability of BCPR, survival, ROSC before admission, and neurological outcome.

scholarly journals Impact of Cardiopulmonary Resuscitation Duration on the Neurological Outcomes of Out-of-Hospital Cardiac Arrest

2021 ◽  
Author(s):  
HISSAH ALBINALI ◽  
Arwa Alumran ◽  
Saja AlRayes
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Cerebral Performance Category ◽  
Bivariate Analysis ◽  
Neurological Outcomes ◽  
Risk Of Death ◽  
Secondary Hospital ◽  
The Impact ◽  
Hospital Cardiac Arrest

Abstract Background: Patients experiencing cardiac arrest outside medical facilities are at greater risk of death and might have negative neurological outcomes. Cardiopulmonary resuscitation duration affects neurological outcomes of such patients, which suggests that duration of CPR may be vital to patient outcomes.Objectives: The study aims to evaluate the impact of cardiopulmonary resuscitation duration on neurological outcome of patients who have suffered out-of-hospital cardiac arrest.Methods: Data were collected from emergency cases handled by a secondary hospital in industrial Jubail, Saudi Arabia, between 2015 and 2020. There were 257 out-of-hospital cardiac arrest cases, 236 of which resulted in death.Results: Bivariate analysis showed no significant association between cerebral performance category (CPC) outcomes and duration of CPR, gender and cause of death whereas there is statistically significant between CPC and age. (p = 0.001). However, a good CPC outcome was reported with a (mean) limited duration of 8.1 min of CPR; whereas, poor CPC outcomes were associated with prolonged periods of CPR, 13.2 min (mean). Similarly, youthfulness was associated with good CPC outcomes as revealed by the mean age of 5.8 years, whereas a mean rank of 14.9 years was aligned with a poor CPC outcome.Conclusion: Cardiopulmonary Resuscitation Duration out-of-hospital cardiac arrest does not significantly influence the patient neurological outcome in the current study hospital. Other variables may have a more significant effect.

scholarly journals Protocol for a cohort study of the impact of the COVID-19 pandemic on the rate and incidence of bystander cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Ingvild B. M. Tjelmeland ◽  
Jan Wnent ◽  
Siobhan Masterson ◽  
Jo Kramer-Johansen ◽  
Jan-Thorsten Gräsner
Keyword(s):  
Cardiac Arrest ◽  
Cohort Study ◽  
Cardiopulmonary Resuscitation ◽  
Early Recognition ◽  
Aggregated Data ◽  
General Data Protection Regulation ◽  
Number Of Patients ◽  
Bystander Cpr ◽  
The Impact ◽  
Hospital Cardiac Arrest

Abstract Background Survival after out-of-hospital cardiac arrest (OHCA) is dependent on early recognition, early cardiopulmonary resuscitation (CPR) and early defibrillation. The purpose of CPR is to maintain some blood flow until the arrival of the emergency medical services (EMS). Our concern is that the COVID-19 pandemic has had a negative effect on the number of patients who get CPR before EMS arrival. The aim of this study is to compare the incidence of bystander CPR during the pandemic with data from before the pandemic. Methods The protocol is for a retrospective cohort study where data from existing registries will be used. All participating registries will share aggregated data from 2017 to 2020, and the study team will compare the results from 2020 to results from 2017 to 2019. Due to the General Data Protection Regulation, each participating registry will check for completeness and plausibility, and perform all aggregation of data locally. In the following analysis different registries will be considered as random samples and analysed by means of a generalized linear mixed effects model with Poisson distribution for the outcome, the population covered as offsets, and different registries as random factors. Discussion This study does not present the prospect of direct benefit to the patient, but does provide an opportunity to gain a better understanding of the epidemiology of bystander CPR for OHCA patients during a pandemic. By comparing data during the pandemic with already collected information in established registries we believe we can gain valuable information about changes in public response to out-of-hospital cardiac arrest.

scholarly journals Factors Affecting a Successful Out-Of-Hospital Cardiopulmonary Resuscitation / Pirmsslimnīcas Etapa Kardiopulmonālo Reanimāciju Rezultātus Ietekmējošie Faktori

2014 ◽  
Vol 68 (5-6) ◽  
pp. 228-231
Author(s):  
Kaspars Setlers ◽  
Indulis Vanags ◽  
Anita Kalēja
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Hospital Admission ◽  
Heart Rhythm ◽  
Patient Characteristics ◽  
Spontaneous Circulation ◽  
Factors Affecting ◽  
Bystander Cpr ◽  
And Gender ◽  
Hospital Cardiac Arrest

Abstract A retrospective patient record analysis of the Emergency Medial Service’s Rîga City Regional Centre was provided from January 2012 through December 2013. 1359 adult patients were CPR treated for out-of-hospital cardiac arrest according to ERC Guidelines 2010. A total of 490 patients were excluded from the study. The main outcome measure was survival to hospital admission. Of 869 CPR-treated patients, 60% (n = 521) were men. The mean age of patients was 66.68 ± 15.28 years. The survival rate to hospital admission was 12.9% (n = 112). 54 of survived patients were women. Mean patient age of successful CPR was 63.22 ± 16.21 and unsuccessful CPR 67.20 ± 15.09. At least one related illness was recorded with 63.4% (n = 551) patients. There were 61 survivors in bystander witnessed OHCA and nine survivors in unwitnessed OHCA. The rate of bystander CPR when CA (cardiac arrest) was witnessed was 24.8%. Ventricular fibrillation (VF) as initial heart rhythm was significantly associated with survival to hospital admission in 54 cases (p < 0.0001). Age and gender affected return of spontaneous circulation. Survival to hospital admission had rhythm-specific outcome. Presence of OHCA witnesses improved outcome compared to bystander CPR. The objective of this study was to report patient characteristics, the role of witnesses in out-of-hospital cardiac arrest (OHCA) and outcome of adult cardiopulmonary resuscitation

scholarly journals Impact of dispatcher-assisted cardiopulmonary resuscitation and myResponder mobile app on bystander resuscitation

2021 ◽  
Vol 50 (3) ◽  
pp. 212-221 ◽  
Author(s):  
Xiang Yi Wong ◽  
Qiao Fan ◽  
Nur Shahidah ◽  
Carl Ross De Souza ◽  
Shalini Arulanandam ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Time Series Data ◽  
Mobile App ◽  
Community Level ◽  
Series Data ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Time Periods ◽  
The Impact ◽  
Hospital Cardiac Arrest

Introduction: Bystander cardiopulmonary resuscitation (B-CPR) is associated with improved out-ofhospital cardiac arrest survival. Community-level interventions including dispatcher-assisted CPR (DA-CPR) and myResponder were implemented to increase B-CPR. We sought to assess whether these interventions increased B-CPR. Methods: The Singapore out-of-hospital cardiac arrest registry captured cases that occurred between 2010 and 2017. Outcomes occurring in 3 time periods (Baseline, DA-CPR, and DA-CPR plus myResponder) were compared. Segmented regression of time-series data was conducted to investigate our intervention impact on the temporal changes in B-CPR. Results: A total of 13,829 out-of-hospital cardiac arrest cases were included from April 2010 to December 2017. Higher B-CPR rates (24.8% versus 50.8% vs 64.4%) were observed across the 3 time periods. B-CPR rates showed an increasing but plateauing trend. DA-CPR implementation was significantly associated with an increased B-CPR (level odds ratio [OR] 2.26, 95% confidence interval [CI] 1.79–2.88; trend OR 1.03, 95% CI 1.01–1.04), while no positive change was detected with myResponder (level OR 0.95, 95% CI 0.82–1.11; trend OR 0.99, 95% CI 0.98–1.00). Conclusion: B-CPR rates in Singapore have been increasing alongside the implementation of community-level interventions such as DA-CPR and myResponder. DA-CPR was associated with improved odds of receiving B-CPR over time while the impact of myResponder was less clear.

scholarly journals Association Between Neurological Outcomes and Extreme Hyperoxia in Patients with Out-of-Hospital Cardiac Arrest Who Underwent Extracorporeal Cardiopulmonary Resuscitation: A Retrospective Observational Study from a Multicenter Registry

2021 ◽  
Author(s):  
Masahiro Kashiura ◽  
Hideto Yasuda ◽  
Yuki Kishihara ◽  
Keiichiro Tominaga ◽  
Masaaki Nishihara ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Analysis Model ◽  
Neurological Outcomes ◽  
Arterial Blood ◽  
The Impact ◽  
Hospital Cardiac Arrest

Abstract Background: To investigate the impact of hyperoxia that developed immediately after extracorporeal membrane oxygenation (ECMO)-assisted cardiopulmonary resuscitation (ECPR) on patients’ 30-day neurological outcomes after out-of-hospital cardiac arrest (OHCA). Methods: This study retrospectively analyzed data from the Japanese OHCA registry from June 2014 to December 2017. We analyzed adult patients (18 years or older) who had undergone ECPR. Eligible patients were divided into the following three groups based on their initial partial pressure of oxygen in arterial blood (PaO2) levels after ECMO pump-on: normoxia group, PaO2 ≤ 200 mm Hg; moderate hyperoxia group, 200 mm Hg < PaO2 ≤ 400 mm Hg; and extreme hyperoxia group, PaO2 > 400 mm Hg. The primary and secondary outcomes were 30-day favorable neurological outcomes. Logistic regression statistical analysis model of 30-day favorable neurological outcomes was performed after adjusting for multiple propensity scores calculated using pre-ECPR covariates and for confounding factors post-ECPR.Results: Of the 34 754 patients with OHCA enrolled in the registry, 847 were included. The median PaO2 level was 300 mm Hg (interquartile range: 148–427 mm Hg). Among the eligible patients, 277, 313, and 257 were categorized as normoxic, moderately hyperoxic, and extremely hyperoxic, respectively. Moderate hyperoxia was not significantly associated with neurologically favorable outcomes compared with normoxia as a reference (adjusted odds ratio, 0.86; 95% confidence interval: 0.55–1.35; p = 0.51). However, extreme hyperoxia was associated with less neurologically favorable outcomes when compared with normoxia (adjusted odds ratio, 0.48; 95% confidence interval: 0.29–0.82; p = 0.007).Conclusions: For patients with OHCA who received ECPR, extreme hyperoxia (PaO2 > 400 mm Hg) was associated with poor neurological outcomes. Avoidance of extreme hyperoxia may improve neurological outcomes in patients with OHCA treated with ECPR.

P6379The impact of coronary artery evaluation and intervention to predict mortality and neurological outcome in out-of-hospital cardiac arrest patients with extra corporeal cardiopulmonary resuscitation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Kato ◽  
J Matsuda
Keyword(s):  
Cardiac Arrest ◽  
Coronary Artery ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Low Flow ◽  
Good Neurological Outcome ◽  
The Impact ◽  
Hospital Cardiac Arrest

Abstract Background Refractory cardiac arrest (CA), as defined by the absence of a return of spontaneous circulation (ROSC) is associated with poor prognosis. Current guidelines advocate the use of extracorporeal cardiopulmonary resuscitation (ECPR) for selected patients with CA. Although previous studies have reported the association of survival with some prognostic factors such as age, bystander CPR attempt, low-flow duration or lactate serum level, the impact of the evaluation of coronary artery by coronary angiography (CAG) and the revascularization of coronary artery stenosis have not been sufficiently elucidated. Purpose We sought to investigate impact of the CAG and the revascularization of coronary artery stenosis to predict mortality and neurological outcome at 30 days in out-of-hospital CA (OHCA) patients resuscitated by ECPR. Methods 1382 out-of-hospital cardiac arrest patients were transferred to our critical care center, of which 899 patients with refractory CA at the emergency department were extracted from the institutional consecutive database between January 2015 and December 2018. Among those patients, we performed ECPR for 85 patients, who were successfully resuscitated. To predict mortality in hospital and neurological outcome at 30 days, we investigated basic patients' characteristics, pre-hospital information, and post-hospital care including CAG and coronary revascularization. Results Among those who had first resuscitated by ECPR, 20 patients (23.5%) survived and 10 patients (11.8%) achieved good neurological outcome (cerebral-performance-category (CPC) =1 or 2) at 30 days. We performed CAG for 40 patients (47.1%) and revascularization by percutaneous coronary intervention for 25 patients (29.4%). Younger age (P=0.037), CAG (P=0.001), PCI (P=0.001), and hypothermia therapy (P<0.001) were associated with low mortality. In the multivariate analysis, age (Odds ratio (OR) 0.95; 95% confidence interval (CI) 0.91–0.99; P=0.0025), PCI (OR 4.5; 95% CI 1.15–17.6; P=0.031), and hypothermia therapy (OR 13.7; 95% CI 1.52–124; P=0.020) were independent predictors of 30-days survival. Without diabetes mellitus (P=0.024), CAG (P<0.001), PCI (P=0.006), and hypothermia therapy (P=0.038) were associated with good neurological outcome. PCI (OR 7.39; 95% CI 1.73–31.6; P<0.001) was independently predictive for good neurological outcome. Conclusions Successful PCI was an independent predictor of 30-days survival and good neurological outcome in OHCA patients who were resuscitated by ECPR.

scholarly journals Impact of Cardiopulmonary Resuscitation Duration on Survival of Out-of-Hospital Cardiac Arrest

2021 ◽  
Author(s):  
Hissah Albinali ◽  
Arwa Alumran ◽  
Saja Alrayes
Keyword(s):  
Cardiac Arrest ◽  
Standard Deviation ◽  
Cardiopulmonary Resuscitation ◽  
Bivariate Analysis ◽  
Risk Of Death ◽  
Medical Facilities ◽  
The Mean ◽  
Secondary Hospital ◽  
The Impact ◽  
Hospital Cardiac Arrest

Abstract Background: Patients experiencing cardiac arrest outside medical facilities are at greater risk of death and might have negative outcomes. Cardiopulmonary resuscitation duration affects survival of such patients, which suggests that duration of CPR may be vital to patient outcomes.Objectives: The study aims to evaluate the impact of cardiopulmonary resuscitation duration on survival of patients who have suffered out-of-hospital cardiac arrest.Methods: Data were collected from emergency cases handled by a secondary hospital in industrial Jubail, Saudi Arabia, between 2015 and 2020. There were 257 out-of-hospital cardiac arrest cases, 236 of which resulted in death.Results: Bivariate analysis showed no significant association between duration of CPR, gender, and cause of death whereas there is statistically significant between duration of CPR and age (p = 0.014). Hence, the results revealed that death was more likely in elderly patients. The mean and standard deviation for the duration of emergency CPR procedures specifically in surviving patients were 26.5 ± 7.20 min, whereas in patients who died after the procedure, the mean and standard deviation for the duration of CPR were 29.6 ± 9.15 min. The mean age and standard deviation in surviving patients were found to be 38 ± 18.59 years, and 49.4 ± 23.39 years for those who died.Conclusion: Cardiopulmonary Resuscitation Duration out-of-hospital cardiac arrest does not significantly influence the patient survival in the current study hospital. Other variables may have a more significant effect.

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