Editor’s Choice-Progress in the chain of survival and its impact on outcomes of patients admitted to a specialized high-volume cardiac arrest center during the past two decades

Autor: Raphael van Tulder, Pia Hubner, Angelika Buchinger, Lorenz Koller, Andreas Zajicek, Nikolaus Graf, Andreas Schober, Anton N. Laggner, Alexander O. Spiel, Patrick Sulzgruber, Thomas Uray, Christoph Schriefl, Gerhard Ruzicka, Fritz Sterz, Diana El-Tattan, Christian Wallmüller
Rok vydání: 2016
Předmět:
Male
Emergency Medical Services
medicine.medical_specialty
medicine.medical_treatment
030204 cardiovascular system & hematology
Critical Care and Intensive Care Medicine
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Hypothermia
Induced
medicine
Emergency medical services
Humans
Chain of survival
Prospective Studies
Cardiopulmonary resuscitation
Intensive care medicine
Prospective cohort study
Survival rate
Survival analysis
Aged
business.industry
Percutaneous coronary intervention
Basic life support
030208 emergency & critical care medicine
General Medicine
Middle Aged
Survival Analysis
Cardiopulmonary Resuscitation
Survival Rate
Treatment Outcome
Austria
Female
sense organs
Cardiology and Cardiovascular Medicine
business
Out-of-Hospital Cardiac Arrest
Zdroj: European Heart Journal: Acute Cardiovascular Care. 5:3-12
ISSN: 2048-8734
2048-8726
Popis: Cardiac arrest (CA) is still associated with high mortality and morbidity. Data on the changes in management and outcomes over a long period of time are limited. Using data from a single emergency department (ED), we assessed changes over two decades.In this single-center observational study, we prospectively included 4133 patients receiving cardiopulmonary resuscitation and being admitted to the ED of a tertiary care hospital between January 1992 and December 2012.There was a significant improvement in both 6-month survival rates (+10.8%; p 0.001) and favorable neurological outcome (+4.7%; p 0.001). While the number of witnessed CA cases decreased (-4.7%; p 0.001) the proportion of patients receiving bystander basic life support increased (+8.3%; p 0.001). The proportion of patients with initially shockable ECG rhythms remained unchanged, but cardiovascular causes of CA decreased (-9.6%; p 0.001). Interestingly, the time from CA until ED admission increased (+0.1 hours; p = 0.024). The use of percutaneous coronary intervention and therapeutic hypothermia were significantly associated with survival.Outcomes of patients with CA treated at a specialized ED have improved significantly within the last 20 years. Improvements in every link in the chain of survival were noted.
Databáze: OpenAIRE
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