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 |
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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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