scholarly journals Results of the implementation of integrated care after cardiorespiratory arrest in a university hospital

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Evelyn Carla Borsari Mauricio ◽  
Maria Carolina Barbosa Teixeira Lopes ◽  
Ruth Ester Assayag Batista ◽  
Meiry Fernanda Pinto Okuno ◽  
Cássia Regina Vancini Campanharo
Keyword(s):  
Medical Records ◽  
Neurological Status ◽  
Spontaneous Circulation ◽  
University Hospital ◽  
Cardiorespiratory Arrest ◽  
Advanced Airway ◽  
One Year ◽  
Airway Access ◽  
Discharge Method

ABSTRACT Objectives: to identify the care measures performed after cardiorespiratory arrest (CRA) and to relate them to the neurological status and survival at four moments: within the first 24 hours, at the discharge, six months after discharge, and one year after discharge. Method: retrospective, analytical and quantitative study performed at the Emergency Department of a university hospital in São Paulo. Eighty-eight medical records of CRA patients who had a return of spontaneous circulation sustained for more than 20 minutes were included and the post-CRA care measures performed in the first 24 hours were identified, as well as its relationship with survival and neurological status. Results: the most frequent post-CRA care measures were use of advanced airway access techniques and indwelling bladder catheterization. Patients who had maintained good breathing and circulation, temperature control and who were transferred to intensive care unit had a better survival in the first 24 hours, after six months and one year after discharge. Good neurological status at six months and one year after discharge was associated with non-use of vasoactive drugs and investigation of the causes of the CRA. Conclusion: the identification of good practices in post-CRA care may help to reduce the mortality of these individuals and to improve their quality of life.

scholarly journals Prevalence of Provocative Seizures in Persons with Epilepsy: A Longitudinal Study at Khon Kaen University Hospital, Thailand

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Nutthaya Vongkasamchai ◽  
Sunee Lertsinudom ◽  
Acharawan Topark-Ngarm ◽  
Udomlack Peansukwech ◽  
Kittisak Sawanyawisuth ◽  
...  
Keyword(s):  
Medical Records ◽  
Causative Factor ◽  
University Hospital ◽  
Limited Data ◽  
Asian Populations ◽  
Khon Kaen ◽  
The Mean ◽  
One Year ◽  
Seizure Attacks

Background and Objective. Provocative factors are one causative factor of seizure attacks in persons with epilepsy (PWE). There are limited data of prevalence and major provocative factors in Asian populations.Methods. This study was performed at the Epilepsy Clinic, Khon Kaen University Hospital. The patients who aged 15 years or over, who had been treated at least 3 months with at least one antiepileptic drug, and who were followed up for at least one year were included. Data of seizure control and triggers were collected retrospectively from medical records. Data analysis was performed to identify independent provocative factors.Results. A total of 382 PWE met the study criteria. The mean age was40.4±0.8years. Approximately 44% of the patients had at least one provocative factor. By multivariate analysis, the independent provocative factors with the first three highest adjusted odds ratios were sleep deprivation (adjustedOR=8.64, 95% CI 3.73–19.99), alcohol consumption (adjustedOR=6.76, 95% CI 1.44–31.78), and feeling stressful (adjustedOR=2.97, 95% CI 1.29–6.86).Conclusion. Almost half of seizure attacks may be caused by provocative factors in Thai PWEs and some factors may be preventable. Avoidance of these factors should be emphasized to epilepsy patients for improving clinical outcomes and quality of life.

The Use of Children's Medical Records to Predict the Risk of Asthma Attack

1995 ◽  
Vol 40 (5) ◽  
pp. 138-140 ◽  
Author(s):  
R.G. Neville ◽  
F.P. Bryce ◽  
R.A. Clark ◽  
I K Crombie
Keyword(s):  
Childhood Asthma ◽  
Medical Records ◽  
Respiratory Symptoms ◽  
Respiratory Infections ◽  
Large Data ◽  
Respiratory Morbidity ◽  
Asthma Attack ◽  
One Year ◽  
Subsequent Risk

Using a large data base of respiratory morbidity in children the opportunity arose to explore the link between what was written in general practice case records and the subsequent risk of a child developing an asthma attack or hospital admission due to asthma. Children with five or more consultations in one year for respiratory symptoms had a 33% risk of experiencing an asthma attack or 7.1% risk of admission in the following year. Twenty seven percent of children who received antibiotics for “respiratory infections” subsequently had an asthma attack. The potential exists to review past and present symptoms and thus attempt to predict future morbidity. Childhood asthma is an example where the quality of care offered by general practitioners could be improved if a precise estimate of risk could be used to modify clinical management.

scholarly journals Advantages of a cohort study on cardiac arrest conducted by nurses

2015 ◽  
Vol 49 (5) ◽  
pp. 762-766
Author(s):  
Cássia Regina Vancini Campanharo ◽  
Rodrigo Luiz Vancini ◽  
Maria Carolina Barbosa Teixeira Lopes ◽  
Meiry Fernanda Pinto Okuno ◽  
Ruth Ester Assayag Batista ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cohort Study ◽  
Neurological Status ◽  
University Hospital ◽  
Training Strategy ◽  
Factors Associated ◽  
Disease Outcomes ◽  
Telephone Calls ◽  
One Year ◽  
And Training

AbstractOBJECTIVEIdentifying factors associated to survival after cardiac arrest.METHODAn experience report of a cohort study conducted in a university hospital, with a consecutive sample comprised of 285 patients. Data were collected for a year by trained nurses. The training strategy was conducted through an expository dialogue lecture. Collection monitoring was carried out by nurses via telephone calls, visits to the emergency room and by medical record searches. The neurological status of survivors was evaluated at discharge, after six months and one year.RESULTSOf the 285 patients, 16 survived until hospital discharge, and 13 remained alive after one year, making possible to identify factors associated with survival. There were no losses in the process.CONCLUSIONCohort studies help identify risks and disease outcomes. Considering cardiac arrest, they can subsidize public policies, encourage future studies and training programs for CPR, thereby improving the prognosis of patients.

Long-term effects of a Swedish lifestyle intervention programme on lifestyle habits and quality of life in people with increased cardiovascular risk

2017 ◽  
Vol 46 (6) ◽  
pp. 613-622 ◽  
Author(s):  
Matthias Lidin ◽  
Elin Ekblom-Bak ◽  
Monica Rydell Karlsson ◽  
Mai-Lis Hellénius
Keyword(s):  
Quality Of Life ◽  
Cardiovascular Risk ◽  
Dietary Habits ◽  
Behavioural Change ◽  
University Hospital ◽  
Intervention Programme ◽  
Lifestyle Habits ◽  
Group Sessions ◽  
One Year

Aims: The aim of this study was to evaluate the effects of a structured intervention programme on lifestyle habits and quality of life after six months and one year in participants with increased cardiovascular risk. Methods: Participants aged ≥18 years with increased cardiovascular risk were referred from primary health care and hospitals. The programme was launched at an outpatient clinic in a department of cardiology at a university hospital. It consisted of individual visits to a nurse for a health check-up and lifestyle counselling at baseline, after six months and at one year. In addition, five group sessions – focusing on nicotine, alcohol, physical activity, eating habits, stress, sleep and behavioural change – were offered to the participants and their relatives or friends. Lifestyle habits and quality of life were assessed with questionnaires at baseline, after six months and at one year. Results: One hundred participants (64 women, 36 men, age 58±11 years) were included in the programme. Compared with the baseline, significant and favourable changes in reported lifestyle habits were noted. Exercise levels were higher after one year and sedentary time decreased from 7.4 to 6.3 h/day. Dietary habits improved and the number of participants with a high consumption of alcohol decreased. Quality of life improved after one year. Conclusions: Participating in a structured lifestyle programme resulted in improved lifestyle habits and quality of life over one year in people with increased cardiovascular risk. Components such as an inter-professional teamwork, a focus on lifestyle rather than the disease, and combining individual visits and group sessions, might be central to the positive outcome of the programme.

scholarly journals Survival and Long-term Outcomes Following in-hospital Cardiac Arrest in a Swiss University Hospital: a Prospective Observational Study

2021 ◽  
Author(s):  
Alexander Fuchs ◽  
Dominic Käser ◽  
Lorenz Theiler ◽  
Robert Greif ◽  
Jürgen Knapp ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Functional Status ◽  
Survival Rates ◽  
Neurological Status ◽  
Spontaneous Circulation ◽  
University Hospital ◽  
Return Of Spontaneous Circulation ◽  
Team Interventions ◽  
Hospital Cardiac Arrest ◽  
Cardiac Arrest Team

Abstract Background: Incidence of in-hospital cardiac arrest is reported to be 0.8 to 4.6 per 1,000 patient admissions. Patient survival to hospital discharge with favourable functional and neurological status is around 21%. The Bern University Hospital is a tertiary medical centre in Switzerland with a cardiac arrest team from the Department of Anaesthesiology and Pain Medicine that is available 24 h per day, 7 days per week. Due to lack of central documentation of cardiac arrest team interventions, the incidence, outcomes and survival rates of cardiac arrests are unknown. The aim was thus to record all cardiac arrest team interventions over 1 year, and to analyse the outcome and survival rates of adult patients after in-hospital cardiac arrests.Methods: We conducted a prospective single-centre observational study that recorded all adult in-hospital cardiac arrest team interventions over 1 year, using an Utstein-style case report form. The primary outcome was 30-day survival after in-hospital cardiac arrest. Secondary outcomes were return of spontaneous circulation, neurological status (after return of spontaneous circulation, after 24 h, after 30 days and 1 year), according to the Glasgow Outcomes Scale, and functional status at 30 days and 1 year, according to the Short-form-12 Health Survey.Results: The cardiac arrest team had 146 interventions over the study year, which included 60 non-life-threatening alarms (41.1%). The remaining 86 (58.9%) acute life-threatening situations included 68 (79.1%) as patients with cardiac arrest. The mean age of these cardiac arrest patients was 68 ±13 years, with a male predominance (51/68; 75.0%). Return of spontaneous circulation was recorded in 49 patients (72.1%). Over one-third of the cardiac arrest patients (27/68) were alive after 30 days with favourable neurological outcome. The patients who survived to 1 year after the event showed favourable neurological and functional status. Conclusions: The in-hospital cardiac arrest incidence on a large tertiary Swiss university hospital was 1.56 per 1,000 patient admissions. After a cardiac arrest, about a third of the patients survived to 1 year with favourable neurological and functional status. Early recognition and high-quality cardiopulmonary resuscitation provided by a well-organised team is crucial for patient survival.Trial Registration: The trial was registered in clinicaltrials.gov (NCT02746640).

scholarly journals Post-cardiac arrest syndrome in adult hospitalized patients

2021 ◽  
Author(s):  
Estivalis G. Acosta-Gutiérrez ◽  
Andrés M. Alba-Amaya ◽  
Santiago Roncancio-Rodríguez ◽  
José Ricardo Navarro-Vargas
Keyword(s):  
Cardiac Arrest ◽  
Latin American ◽  
Myocardial Dysfunction ◽  
Spontaneous Circulation ◽  
Neurologic Recovery ◽  
One Year ◽  
Meta Analyses ◽  
Post Cardiac Arrest Syndrome ◽  
Hospital Cardiac Arrest

Adult In-hospital Cardiac Arrest (IHCA) is defined as the loss of circulation of an in-patient. Following high-quality cardiopulmonary resuscitation (CPR), if the return of spontaneous circulation (ROSC) is achieved, the post-cardiac arrest syndrome develops (PCAS). This review is intended to discuss the current diagnosis and treatment of PCAS. To approach this topic, a bibliography search was conducted through direct digital access to the scientific literature published in English and Spanish between 2014 and 2020, in MedLine, SciELO, Embase and Cochrane. This search resulted in 248 articles from which original articles, systematic reviews, meta-analyses and clinical practice guidelines were selected for a total of 56 documents. The etiologies may be divided into 56% of in-hospital cardiac, and 44% of non-cardiac arrests. The incidence of this physiological collapse is up to 1.6 cases/1,000 patients admitted, and its frequency is higher in the intensive care units (ICU), with an overall survival rate of 13% at one year. The primary components of PCAS are brain injury, myocardial dysfunction and the persistence of the precipitating pathology. The mainstays for managing PCAS are the prevention of cardiac arrest, ventilation support, control of peri-cardiac arrest arrythmias, and interventions to optimize neurologic recovery. A knowledgeable healthcare staff in PCAS results in improved patient survival and future quality of life. Finally, there is clear need to do further research in the Latin American Population.

scholarly journals Quality of life of men with AIDS and the model of social determinants of health

2015 ◽  
Vol 23 (2) ◽  
pp. 183-191 ◽  
Author(s):  
Gilmara Holanda da Cunha ◽  
Maria Luciana Teles Fiuza ◽  
Elucir Gir ◽  
Priscila de Souza Aquino ◽  
Ana Karina Bezerra Pinheiro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Cross Sectional Study ◽  
Determinants Of Health ◽  
University Hospital ◽  
Cross Sectional ◽  
Institutional Review ◽  
One Year

OBJECTIVE: to analyze the quality of life (QoL) of men with AIDS from the perspective of the model of social determinants of health (MSDH). METHOD: cross-sectional study conducted in an outpatient infectious diseases clinic from a Brazilian university hospital over the course of one year with a sample of 138 patients. A form based on the MSDH was used to collect sociodemographic data addressing individual, proximal, intermediate determinants and the influence of social networks together with an instrument used to assess the QoL of people with HIV/AIDS. The project was approved by the Institutional Review Board (Protocol No. 040.06.12). RESULTS: according to MSDH, most men with AIDS were between 30 and 49 years old (68.1%), mixed race (59.4%), heterosexual (46.4%), single (64.5%), Catholic (68.8%), had a bachelor's degree (39.2%), had no children (61.6%), and had a formal job (71.0%). The perception of QoL in the physical, level of independence, environment, and spirituality domains was intermediate, while QoL was perceived to be superior in the domains of psychological and social relationship. A perception of lower QoL was presented by homosexual (p=0.037) and married men (p=0.077), and those with income below one times the minimum wage (p=0.042). A perception of greater QoL was presented by those without a religion (p=0.005), living with a partner (p=0.049), and those who had a formal job (p=0.045). CONCLUSION: social determinants influence the QoL of men with AIDS.

Recurrent acute otitis media detracts from health-related quality of life

2017 ◽  
Vol 131 (2) ◽  
pp. 128-137 ◽  
Author(s):  
T Kujala ◽  
O-P Alho ◽  
A Kristo ◽  
M Uhari ◽  
M Renko ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
University Hospital ◽  
Healthy Children ◽  
Recurrent Acute Otitis Media ◽  
Related Quality ◽  
Health Related ◽  
One Year

AbstractObjective:Acute otitis media causes discomfort to children and inconvenience to their parents. This study evaluated the quality of life in children with recurrent acute otitis media aged less than 24 months.Methods:Quality of life was evaluated in 149 children aged 10 to 24 months who were referred to the Oulu University Hospital on account of recurrent acute otitis media. The children were treated with or without surgery. Age-matched controls were selected randomly from the general child population. Parents completed the Child Health Questionnaire.Results:The children with recurrent acute otitis media had a significantly poorer quality of life than control children. The control children with a history of a few acute otitis media episodes had a significantly poorer quality of life than those without any such history. The quality of life of the children with recurrent acute otitis media improved during the one-year follow up, regardless of the treatment, but did not reach the same level as healthy children.Conclusion:Acute otitis media detracted from quality of life when a generic measure was used. The mode of treatment used to prevent further recurrences of acute otitis media did not influence quality of life improvement.

Abstract 371: Using Defibrillator Bioimpedance Waveforms to Measure Ventilation During Continuous Chest Compression CPR

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Teresa R Gordon ◽  
Enrique Rueda ◽  
Elisabete Aramendi ◽  
Unai Irusta ◽  
Pamela Owens ◽  
...  
Keyword(s):  
Chest Compression ◽  
Heart Rhythm ◽  
Spontaneous Circulation ◽  
Chest Compressions ◽  
Emergency Responders ◽  
Advanced Airway ◽  
Lower Amplitude ◽  
Waveform Amplitude ◽  
Ventilation Rates

Introduction: For patients with out of hospital cardiac arrest, prompt return of circulation and ventilation is vitally important for survival. Techniques and devices have been developed to ensure emergency responders are providing high quality chest compression, but there has been little progress in the area of ventilation. Until an advanced airway is placed, there has been no practical way to measure ventilation. The aim of this study is to develop a method to measure ventilation during continuous chest compressions cardiopulmonary resuscitation (CPR) that can be used to monitor and improve quality of ventilation during out of hospital CPR. Hypothesis: Defibrillator transthoracic bioimpedance can be used to identify ventilation waveforms prior to placement of an advanced airway during continuous chest compressions CPR. Methods: We examined 391 patients’ defibrillator files from four Resuscitation Outcomes Consortium sites for the presence of waveforms that met previously developed criteria and were manually annotated. Criteria for an acceptable ventilation waveform were: waveform amplitude ≥0.5 Ohm and waveform duration ≥1 sec. We recorded the number of ventilations, return of spontaneous circulation, initial heart rhythm, and ventilation rates. Following annotation, 333 of the 391 patients’ files had the necessary intubation time recorded and an automated program precisely measured the amplitude and duration of each ventilation. We determined mean (±SD) waveform amplitude and duration of inflation and deflation pre and post airway placement. Significance was determined using Wilcoxon ranked sum test. Results: Comparing the pre and post airway measurements did not result in any significant differences, except in duration of inflation, which was 1.06 ± 0.41 sec and 1.11 ± 0.52 sec, respectively, (p <0.001). Ventilation waveforms had significantly lower amplitude and shorter duration during chest compressions than during pauses in compressions. Conclusion: Defibrillator transthoracic bioimpedance can be used to identify and monitor ventilations during continuous chest compressions CPR. Ventilation waveforms have lower amplitudes and shorter durations during chest compressions than during pauses in compressions.

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