Aim: Resuscitation of cardiac arrest involves invasive and traumatic interventions and places a large burden on limited EMS resources. Our aim was to identify prehospital cardiac arrests for which resuscitation is extremely unlikely to result in survival to hospital discharge.
Methods: We performed a retrospective cohort analysis of all cardiac arrests in San Mateo County, California, for which paramedics were dispatched, from January 1, 2015 to December 31, 2018, using the Cardiac Arrest Registry to Enhance Survival (CARES) database. We described characteristics of patients, arrests, and EMS responses, and used recursive partitioning to develop decision rules to identify arrests unlikely to survive to hospital discharge, or to survive with good neurologic function.
Results: From 2015-2018, 1750 patients received EMS dispatch for cardiac arrest in San Mateo County. We excluded 44 patients for whom resuscitation was terminated due to DNR directives. Median age was 69 years (IQR 57-81), 563 (33.0%) patients were female, 816 (47.8%) had witnessed arrests, 651 (38.2%) received bystander CPR, 421 (24.7%) had an initial shockable rhythm, and 1178 (69.1%) arrested at home. A simple rule (non-shockable initial rhythm, unwitnessed arrest, and age 80 or greater) excludes 223 (13.1%) arrests, of whom none survived to hospital discharge.
Conclusion: A simple decision rule (non-shockable rhythm, unwitnessed arrest, age ≥ 80) identifies arrests for which resuscitation is futile. If validated, this rule could be applied by EMS policymakers to identify cardiac arrests for which the trauma and expense of resuscitation are extremely unlikely to result in survival.
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http://dx.doi.org/10.1016/j.resuscitation.2019.06.011 | DOI Listing |
Circ Cardiovasc Qual Outcomes
January 2025
Division of Emergency Medical Services, Public Health - Seattle & King County, WA (J.S., J.L., M.P., C.D., J.B., S.G., P.K., T.R.).
Background: Although racial disparities have been described in resuscitation, little is known about potential bias in race classification of out-of-hospital cardiac arrest (OHCA).
Methods: We conducted a retrospective cohort study of adults treated by emergency medical services (EMS) for nontraumatic OHCA in King County, WA between January 1, 2018, and December 31, 2021. We assessed agreement using κ and evaluated patterns of missingness between EMS-assessed race versus comprehensive race classification from hospital and death records.
Emerg Med Int
January 2025
Department of Emergency Medicine, Etlik City Hospital, Ankara, Turkey.
Despite significant medical and technological advancements, cardiac arrest remains a critical public health concern due to its persistently high mortality and morbidity rates. Consequently, research on cardiopulmonary resuscitation (CPR) is of significant importance. This study presents a bibliometric analysis of the 100 most-cited articles in the field of CPR identified using the Scopus database without time restrictions.
View Article and Find Full Text PDFEur Heart J Acute Cardiovasc Care
January 2025
Department of Emergency Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518035, Guangdong, China.
Background: We aimed to analyze the yet unclear correlation between air pollutant concentrations (AP) and out-of-hospital cardiac arrest (OHCA) in Shenzhen, China.
Methods: A 5-year time series analysis of all OHCA events reported to the Shenzhen Emergency Center was conducted. Quasi-Poisson regression, controlling for meteorological variables (daily mean relative temperature and humidity) with multivariable fractional polynomial and using Fourier series to adjust for long-term trends and account for periodic patterns, was used to assess the association among particulate matter of 2.
Zhonghua Er Ke Za Zhi
January 2025
Pediatric Heart Center, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102 China.
To analyze the clinical characteristics,diagnosis and treatment of pediatric myocardial infarction (MI) patients with coronary artery lesions (CAL) after Kawasaki disease (KD). Clinical data including baseline characteristics, KD and CAL information, clinical symptoms at MI onset, electrocardiogram (ECG) and imaging findings, MI treatment, and clinical outcomes of 41 MI patients with CAL after KD admitted to the Children's Hospital of Fudan University from January 2017 to August 2024 were analyzed retrospectively. (1) Demographic characteristics: a total of 41 patients were included (36 males and 5 females).
View Article and Find Full Text PDFEur J Cardiothorac Surg
January 2025
Division of Pediatric Intensive Care, Department of Intensive Care, Leiden University Medical Centre, Leiden, Netherlands.
Background: Extracorporeal membrane oxygenation (ECMO) can act as a bridge to recovery in both pre-and postoperative patients with transposition of the great arteries (TGA). However, literature on its use in these patients is scarce.
Methods: Retrospective single-centre cohort study encompassing all TGA patients who received ECMO between January 2009 and March 2024.
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