scholarly journals Cardiac Arrest during Hospitalization for Delivery in the United States, 1998–2011

2014 ◽  
Vol 120 (4) ◽  
pp. 810-818 ◽  
Author(s):  
Jill M. Mhyre ◽  
Lawrence C. Tsen ◽  
Sharon Einav ◽  
Elena V. Kuklina ◽  
Lisa R. Leffert ◽  
...  
Keyword(s):  
United States ◽  
Heart Failure ◽  
Cardiac Arrest ◽  
Amniotic Fluid ◽  
Cardiopulmonary Arrest ◽  
Temporal Trends ◽  
Survival Rates ◽  
The United States ◽  
Amniotic Fluid Embolism ◽  
Weighted Estimates

Abstract Background: The objective of this analysis was to evaluate the frequency, distribution of potential etiologies, and survival rates of maternal cardiopulmonary arrest during the hospitalization for delivery in the United States. Methods: By using data from the Nationwide Inpatient Sample during the years 1998 through 2011, the authors obtained weighted estimates of the number of U.S. hospitalizations for delivery complicated by maternal cardiac arrest. Clinical and demographic risk factors, potential etiologies, and outcomes were identified and compared in women with and without cardiac arrest. The authors tested for temporal trends in the occurrence and survival associated with maternal arrest. Results: Cardiac arrest complicated 1 in 12,000 or 8.5 per 100,000 hospitalizations for delivery (99% CI, 7.7 to 9.3 per 100,000). The most common potential etiologies of arrest included hemorrhage, heart failure, amniotic fluid embolism, and sepsis. Among patients with cardiac arrest, 58.9% of patients (99% CI, 54.8 to 63.0%) survived to hospital discharge. Conclusions: Approximately 1 in 12,000 hospitalizations for delivery is complicated by cardiac arrest, most frequently due to hemorrhage, heart failure, amniotic fluid embolism, or sepsis. Survival depends on the underlying etiology of arrest.

Abstract 17127: Sports-Related Sudden Cardiac Arrest: Comparison of Survival Outcomes in Europe versus the United States

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Eloi Marijon ◽  
Audrey Uy-Evanado ◽  
Florence Dumas ◽  
Carmen Teodeorescu ◽  
Kyndaron Reinier ◽  
...  
Keyword(s):  
United States ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Response Times ◽  
Survival Rates ◽  
Sudden Cardiac Arrest ◽  
The United States ◽  
Population Based ◽  
Sports Activity ◽  
Bystander Cardiopulmonary Resuscitation

Background: Sports-related sudden cardiac arrest (sport SCA) has always attracted attention and the United States and European Union have developed divergent strategies for prevention over the last decade; notably regarding screening of younger athletes but also for SCA prevention in middle-aged and senior individuals. In this context, the extent to which outcomes of sports SCA differ between Europe and the USA have not been characterized. Methods: SCA cases aged 15-75 years were identified in two large prospective, population-based SCA programs, one in the Paris region (Paris-SDEC) and the other in a Northwestern US metro region (Oregon-SUDS) between 2002 and 2012. Cases of SCA, occurring during sports activity were compared between the two regions. Results: Of the 7,357 cases studied, 290 (4%) occurred during sports, with very similar proportions in both regions: 86 out of 1,894 (4.5%) in Oregon and 204 out of 5,463 (3.8%) in Paris. Subjects’ characteristics of cases in both programs were very similar (Paris vs. Oregon, respectively, for all results following), regarding age (50.7±14 vs. 50.4±13 years, P=0.55), male proportion (94%vs. 92%, P=0.53), past medical history of ≥2 cardiovascular risk factors (16% vs. 23%, P=0.16) and/or heart disease (10% vs. 8%, P=0.55). There was a high proportion of witnessed events in both populations (89% vs. 90%, P=0.94). However, we observed significant differences with more bystander cardiopulmonary resuscitation in Paris (63% vs. 48%, P=0.02), faster response time in Oregon (8.3±6 vs. 6.9±4 min, P=0.05), and more initially shockable rhythms in Oregon (52% vs. 70%, P=0.006). Overall, resuscitation outcomes were very similar for return of spontaneous circulation (26% vs. 33%, P=0.21) and survival to hospital discharge (27% vs. 26%, P=0.80). Conclusions: On either side of the Atlantic, burden and characteristics of sports-related SCA are very similar. Survival rates are approximately one in four cases. Optimizing bystander cardiopulmonary resuscitation rates and emergency response times could further improve outcomes. Deployment of uniform, effective strategies for screening and prevention are likely to make the greatest impact on sports SCA.

Standards for Resuscitation After Cardiac Surgery

2015 ◽  
Vol 35 (2) ◽  
pp. 30-38 ◽  
Author(s):  
S. Jill Ley
Keyword(s):  
United States ◽  
Cardiac Arrest ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Life Support ◽  
Survival Rates ◽  
Advanced Life Support ◽  
The United States ◽  
High Survival ◽  
Essential Components

Of the 250 000 patients who undergo major cardiac operations in the United States annually, 0.7% to 2.9% will experience a postoperative cardiac arrest. Although Advanced Cardiac Life Support (ACLS) is the standard approach to management of cardiac arrest in the United States, it has significant limitations in these patients. The European Resuscitation Council (ERC) has endorsed a new guideline specific to resuscitation after cardiac surgery that advises important, evidence-based deviations from ACLS and is under consideration in the United States. The ACLS and ERC recommendations for resuscitation of these patients are contrasted on the basis of the essential components of care. Key to this approach is the rapid elimination of reversible causes of arrest, followed by either defibrillation or pacing (as appropriate) before external cardiac compressions that can damage the sternotomy, cautious use of epinephrine owing to potential rebound hypertension, and prompt resternotomy (within 5 minutes) to promote optimal cerebral perfusion with internal massage, if prior interventions are unsuccessful. These techniques are relatively simple, reproducible, and easily mastered in Cardiac Surgical Unit–Advanced Life Support courses. Resuscitation of patients after heart surgery presents a unique opportunity to achieve high survival rates with key modifications to ACLS that warrant adoption in the United States.

scholarly journals Temporal Trends in Hospitalization for Acute Decompensated Heart Failure in the United States, 1998–2011

2016 ◽  
Vol 183 (5) ◽  
pp. 462-470 ◽  
Author(s):  
Sunil K. Agarwal ◽  
Lisa Wruck ◽  
Miguel Quibrera ◽  
Kunihiro Matsushita ◽  
Laura R. Loehr ◽  
...  
Keyword(s):  
United States ◽  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Temporal Trends ◽  
Decompensated Heart Failure ◽  
The United States

scholarly journals Geographic Variation in Trends and Disparities in Heart Failure Mortality in the United States, 1999 to 2017

2021 ◽  
Author(s):  
Peter A. Glynn ◽  
Rebecca Molsberry ◽  
Katharine Harrington ◽  
Nilay S. Shah ◽  
Lucia C. Petito ◽  
...  
Keyword(s):  
United States ◽  
Heart Failure ◽  
Cardiovascular Disease ◽  
Geographic Variation ◽  
Temporal Trends ◽  
State Level ◽  
The United States ◽  
The South ◽  
Cardiovascular Disease Mortality ◽  
Disease Mortality

Background Cardiovascular disease mortality related to heart failure (HF) is rising in the United States. It is unknown whether trends in HF mortality are consistent across geographic areas and are associated with state‐level variation in cardiovascular health (CVH). The goal of the present study was to assess regional and state‐level trends in cardiovascular disease mortality related to HF and their association with variation in state‐level CVH. Methods and Results Age‐adjusted mortality rates (AAMR) per 100 000 attributable to HF were ascertained using the Centers for Disease Control and Prevention's Wide‐Ranging Online Data for Epidemiologic Research from 1999 to 2017. CVH at the state‐level was quantified using the Behavioral Risk Factor Surveillance System. Linear regression was used to assess temporal trends in HF AAMR were examined by census region and state and to examine the association between state‐level CVH and HF AAMR. AAMR attributable to HF declined from 1999 to 2011 and increased between 2011 and 2017 across all census regions. Annual increases after 2011 were greatest in the Midwest (β=1.14 [95% CI, 0.75, 1.53]) and South (β=0.96 [0.66, 1.26]). States in the South and Midwest consistently had the highest HF AAMR in all time periods, with Mississippi having the highest AAMR (109.6 [104.5, 114.6] in 2017). Within race‒sex groups, consistent geographic patterns were observed. The variability in HF AAMR was associated with state‐level CVH ( P <0.001). Conclusions Wide geographic variation exists in HF mortality, with the highest rates and greatest recent increases observed in the South and Midwest. Higher levels of poor CVH in these states suggest the potential for interventions to promote CVH and reduce the burden of HF.

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