Change in out-of-hospital 12-lead ECG diagnostic classification following resuscitation from cardiac arrest
| Autor: | Tom P. Aufderheide, Lujia Tang, M. Riccardo Colella, Guillaume Debaty, Rajat Kalra, Benjamin W Weston, Hadi O. Saleh, Thomas W. Engel, John E. Baker, Aniko Szabo, Paul E. Pepe, Demetris Yannopoulos, David D. Gutterman, Jacob Labinski |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Emergency Medical Services medicine.medical_specialty Resuscitation Adolescent 12 lead ecg Emergency Nursing Electrocardiography Internal medicine medicine Emergency medical services Humans cardiovascular diseases Myocardial infarction Aged Retrospective Studies Out of hospital business.industry Incidence (epidemiology) Reproducibility of Results Emergency department Middle Aged medicine.disease Diagnostic classification Hospitals Emergency Medicine Cardiology Cardiology and Cardiovascular Medicine business Out-of-Hospital Cardiac Arrest |
| Zdroj: | Resuscitation. 169:45-52 |
| ISSN: | 0300-9572 |
| DOI: | 10.1016/j.resuscitation.2021.10.012 |
| Popis: | Introduction We evaluated the incidence of change in serial 12-lead electrocardiogram (ECG) diagnostic classifications in patients resuscitated from out-of-hospital (OH) cardiac arrest (OHCA) comparing OH to emergency department (ED) ECGs. Methods This retrospective case series included: 1) adults (≥ 18 years old), 2) resuscitated from OHCA, 3) ≥ 1 OH and 1 ED ECG/patient, and 4) emergency medical services (EMS) transport to the study hospital. OH and ED ECGs were classified as: 1) STEMI (ST-segment Elevation Myocardial Infarction), 2) Ischemic, and 3) Non-ischemic. Two ED physicians and one cardiologist independently classified all ECGs, then generated a consensus opinion classification for each ECG based on American Heart Association’s 2018 Expert Consensus criteria. The most ischemic OH ECG classification was compared with the last ED ECG classification. Results From 7/27/12 to 7/18/19, 176 patients were entered with a mean age of 61.2 ± 16.6 years; 102/176 (58%) were male. Overall, 504 OH and ED 12-lead ECGs were acquired (2.9 ECGs/patient). ECG classification inter-rater reliability kappa score was 0.63 ± 0.02 (substantial agreement). Overall, 86/176 (49%) changed ECG classification from the OH to ED setting; 69/86 (80%) of these ECGs changed from more to less ischemic classifications. Of 49 OH STEMI ECG classifications, 33/49 (67%) changed to a less ischemic (non-STEMI) ED ECG classification. Conclusions Change in 12-lead ECG classification from OH to ED setting in patients resuscitated from OHCA was common (49%). The OH STEMI classification changed to a less ischemic (non-STEMI) ED classification in 67% of cases. |
| Databáze: | OpenAIRE |
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