1
|
Lengen G, Hugli O, De Ridder D, Guessous I, Ladoy A, Joost S, Carron PN. Spatial dependence of non-traumatic out-of-hospital cardiac arrest in a Swiss region: A retrospective analysis. Resusc Plus 2024; 19:100713. [PMID: 39104443 PMCID: PMC11299561 DOI: 10.1016/j.resplu.2024.100713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 06/28/2024] [Indexed: 08/07/2024] Open
Abstract
Background Out-of-hospital cardiac arrest (OHCA) incidence and survival often vary within regions according to patient-related and contextual factors. This study aims to establish the overall spatial dependence of incidence, bystander cardiopulmonary resuscitation (BCPR) and 48-h survival of OHCA with their associated demographic and socioeconomic characteristics in a Swiss region. Methods We conducted a retrospective study using data of all OHCAs recorded between 2007 and 2019 in the canton of Vaud and, more specifically, in the Lausanne area. Provision of BCPR and 48-h survival were analysed using Getis-Ord Gi statistics and OHCA incidence by local Moran's I with empirical Bayes standardised rates. Demographic and socioeconomic characteristics were compared between incidence clusters generated by local Moran's I method. Results Significant spatial variations of OHCA incidence, BCPR and 48-h mortality were observed. Although BCPR was statistically more likely in rural areas, 48-h survival was improved in a few main cities. At the cantonal level, postcode areas with a higher incidence of OHCAs were less densely inhabited with lower salary levels, more Swiss citizens, and an older population. At city level, small area variations were detected within urban neighbourhoods. The more affected hectares with more OHCAs were less inhabited, with a better median salary, more Swiss citizens, and off-centre. Conclusions Spatial variations associated with demographic and socioeconomic factors were observed for OHCA incidence and survival, with sparsely populated areas particularly at risk. These data suggest an unmet need for targeted prevention interventions and structural modifications of the existing prehospital system at the cantonal level.
Collapse
Affiliation(s)
- Guillaume Lengen
- University of Lausanne, Faculty of Biology and Medicine, 21 Rue du Bugnon, 1005 Lausanne, Switzerland
| | - Olivier Hugli
- Emergency Department, Lausanne University Hospital and University of Lausanne, 46 Rue du Bugnon, 1011 Lausanne, Switzerland
| | - David De Ridder
- Geospatial Molecular Epidemiology Group, Laboratory for Biological Geochemistry, School of Architecture, Civil and Environmental Engineering, Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland
- Group of Geographic Information Research and Analysis in Population Health, Switzerland
| | - Idris Guessous
- Group of Geographic Information Research and Analysis in Population Health, Switzerland
- Unit of Population Epidemiology, Division and Department of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland
| | - Anaïs Ladoy
- Geospatial Molecular Epidemiology Group, Laboratory for Biological Geochemistry, School of Architecture, Civil and Environmental Engineering, Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland
- Group of Geographic Information Research and Analysis in Population Health, Switzerland
| | - Stéphane Joost
- Geospatial Molecular Epidemiology Group, Laboratory for Biological Geochemistry, School of Architecture, Civil and Environmental Engineering, Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland
- Group of Geographic Information Research and Analysis in Population Health, Switzerland
- Unit of Population Epidemiology, Division and Department of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland
- ‘La Source’ School of Nursing, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Pierre-Nicolas Carron
- Emergency Department, Lausanne University Hospital and University of Lausanne, 46 Rue du Bugnon, 1011 Lausanne, Switzerland
| |
Collapse
|
2
|
Ravn PB, Falkentoft AC, Garred CAH, Bruhn J, Christensen DM, Sehested TSG, Gislason GH, Køber L, Olsen NT, Torp-Petersen C, Fosbøl E, Bruun NE, Schou M, Ruwald AC. Temporal trends in major cardiovascular events following first-time myocardial infarction in the reperfusion era - a Danish nationwide cohort study from 2000 to 2017. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2023; 9:268-280. [PMID: 36036480 DOI: 10.1093/ehjqcco/qcac033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/01/2022] [Accepted: 06/09/2022] [Indexed: 05/17/2023]
Abstract
AIM We investigated temporal trends in major cardiovascular events following first-time myocardial infarction (MI) and trends in revascularization and pharmacotherapy from 2000 to 2017. METHODS AND RESULTS Using nationwide registries, we identified 120 833 Danish patients with a first-time MI between 2000 and 2017. We investigated 30-day and 1-year mortality and the 1-year risk of first-time admission for heart failure (HF) and recurrent MI. Patients were younger with a higher prevalence of hypertension and diabetes in 2015-2017 compared with 2000-2002. The patients were predominantly male (65.6%), and the median age declined by 3 years through the periods. Percutaneous coronary interventions within 7 days after first-time MI increased significantly (2000: 11.4% vs. 2017: 68.6%; Ptrend < 0.001). Cardiovascular medication after first-time MI changed significantly in the same period. Absolute risks and adjusted rates of outcomes were significantly lower in 2015-2017 compared with 2000-2002: 30-day mortality: 6.5% vs. 14.1% [hazard ratio (HR) 0.52, 95% confidence interval (CI): 0.48-0.55); 1-year mortality 10.7% vs. 21.8% (HR 0.52, 95% CI: 0.50-0.55); recurrent MI: 4.0% vs. 7.8% (HR 0.56, 95% CI: 0.51-0.62); and first-time admission for HF: 2.9% vs. 3.7% (HR 0.82, 95% CI: 0.73-0.92). The rates of 30-day/1-year mortality and recurrent MI showed significantly decreasing trends (Ptrend < 0.001). The rates of first-time admission for HF were borderline significant (Ptrend = 0.045). CONCLUSION From 2000 to 2017, we observed a decreasing risk of recurrent MI, first-time admission for HF, and all-cause mortality in patients with a first-time MI. In the same period, we observed a high rate of guideline-recommended pharmacological treatment after first-time MI as well as increasing rate of early revascularization in Denmark. TRANSLATIONAL PERSPECTIVES The results from the current study portrait the risk of all-cause mortality, recurrent MI, and first-time admission for HF in a real-life setting with a very high utilization of early revascularization and guideline-recommended pharmacological therapy. We observed a temporal trend of improved survival, reduced risk of recurrent MI, as well as reduced risk of first-time admission for HF after first-time MI from 2000 through 2017. We observed an increase in the overall use of revascularization, as well as early revascularization and use of guideline-recommended pharmacotherapy. Our study reveals important results from real-life, nationwide data, showing a reduced risk of cardiovascular outcomes after first-time MI during the past 20 years. Current guidelines are based on results from clinical trials. Our real-life results add additionally important knowledge on patients' prognosis after first-time MI and underline the importance of treating MI according to guideline recommendations.
Collapse
Affiliation(s)
- Pauline Bohsen Ravn
- Department of Cardiology, Herlev and Gentofte University Hospital, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
- Department of Cardiology, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark
| | | | - Caroline A H Garred
- Department of Cardiology, Herlev and Gentofte University Hospital, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
| | - Jonas Bruhn
- Department of Cardiology, Herlev and Gentofte University Hospital, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
| | | | - Thomas S G Sehested
- Department of Cardiology, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark
- The Danish Heart Foundation, Vognmagergade 7, 1120 Copenhagen, Denmark
| | - Gunnar H Gislason
- Department of Cardiology, Herlev and Gentofte University Hospital, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
- The Danish Heart Foundation, Vognmagergade 7, 1120 Copenhagen, Denmark
| | - Lars Køber
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Niels Thue Olsen
- Department of Cardiology, Herlev and Gentofte University Hospital, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
| | - Christian Torp-Petersen
- Department of Cardiology, Aalborg University Hospital, 9000 Aalborg, Denmark
- Department of Cardiology, Nordsjællands Hospital, 3400 Hillerød, Denmark
- Department of Biostatistics, University of Copenhagen, 1165 København, Denmark
| | - Emil Fosbøl
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Niels Eske Bruun
- Department of Cardiology, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark
| | - Morten Schou
- Department of Cardiology, Herlev and Gentofte University Hospital, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
| | - Anne-Christine Ruwald
- Department of Cardiology, Herlev and Gentofte University Hospital, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
- Department of Cardiology, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark
| |
Collapse
|
3
|
Dai M, Chen S, Huang S, Hu J, Jingesi M, Chen Z, Su Y, Yan W, Ji J, Fang D, Yin P, Cheng J, Wang P. Increased emergency cases for out-of-hospital cardiac arrest due to cold spells in Shenzhen, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:1774-1784. [PMID: 35921008 DOI: 10.1007/s11356-022-22332-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
Cold spells have been associated with specific diseases. However, there is insufficient scientific evidence on the effects of cold spells on out-of-hospital cardiac arrest (OHCA). Data on OHCA cases and on meteorological factors and air pollutants were collected between 2013 and 2020. We adopted a quasi-Poisson generalized additive model with a distributed lag nonlinear model (DLNM) to estimate the effect of cold spells on daily OHCA incidence. Backward attributable risk within the DLNM framework was calculated to quantify the disease burden. We compared the effects and OHCA burden of cold spells using nine definitions. The risks of different cold spells on OHCA increased at higher intensities and longer durations. Based on Akaike's information criterion for the quasi-Poisson regression model and the attributable risk, the optimal cold spell was defined as a period in the cold month when the daily mean temperature was below the 10th percentile of the temperature distribution in the study period for at least 2 days. The single-day effect of the optimal cold spell on OHCA occurred immediately and lasted for approximately 1 week. The maximum single-day effect was 1.052 (95% CI: 1.018-1.087) at lag0, while the maximum cumulative effect was 1.433 (95% CI:1.148-1.788) after a 14-day lag. Men were more susceptible to cold spells. Young and middle-aged people were affected by cold spells similar to the elderly. Cold spells can increase the risk of OHCA with an approximately 1-week lag effect. Health regulators should take more targeted measures to protect susceptible populations during cold weather.
Collapse
Affiliation(s)
- Mengyi Dai
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Siyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Jing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Maidina Jingesi
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ziwei Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Youpeng Su
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Weiqi Yan
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Jiajia Ji
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Daokui Fang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Peng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| |
Collapse
|
4
|
Sans Roselló J, Vidal-Burdeus M, Loma-Osorio P, Pons Riverola A, Bonet Pineda G, El Ouaddi N, Aboal J, Ariza Solé A, Scardino C, García-García C, Fernández-Peregrina E, Sionis A. “Impact of age on management and prognosis of resuscitated sudden cardiac death patients”. IJC HEART & VASCULATURE 2022; 40:101036. [PMID: 35514873 PMCID: PMC9062668 DOI: 10.1016/j.ijcha.2022.101036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/27/2022] [Accepted: 04/18/2022] [Indexed: 11/18/2022]
Abstract
Background Sudden cardiac death (SCD) has a great impact on healthcare due to cardiologic and neurological complications. Admissions of elderly people in Cardiology Intensive Care Units have increased. We assessed the impact of age in presentation, therapeutic management and in vital and neurological prognosis of SCD patients. Methods We carried out a retrospective, observational, multicenter registry of patients who were admitted with a SCD in 5 tertiary hospitals from January 2013 to December 2020. We divided our cohort into two groups (patients < 80 years and ≥ 80 years). Clinical, analytical and hemodynamic variables as well as in-hospital management were registered and compared between groups. The degree of neurological dysfunction, vital status at discharge and the influence of age on them were also reviewed. Results We reviewed 1160 patients admitted with a SCD. 11.3% were ≥ 80 years. Use of new antiplatelet agents, performance of a coronary angiography, use of pulmonary artery catheter and temperature control were less carried out in the elderly. Age, non-shockable rhythm, Killip class > 1 at admission, time to CPR initiation > 5 min, time to ROSC > 20 min and lactate > 2 mmol/L were independent predictors for in-hospital mortality. Non-shockable rhythm, Killip class > 1 at admission, time to CPR initiation > 5 min and time to ROSC > 20 min but not age were independent predictors for poor neurological outcomes. Conclusions Age determined a less aggressive management and it was associated with a worse vital prognosis in patients admitted with a SCD. Nevertheless, age was not associated with worse neurological outcomes.
Collapse
Affiliation(s)
- Jordi Sans Roselló
- Cardiology Department. Parc Taulí Hospital Universitari. Sabadell, Spain
- Corresponding autor at: Intensive Cardiac Care Unit. Cardiology Department. Hospital de la Santa Creu i Sant Pau, C/Santa Maria Claret 167, Barcelona 08025, Spain (Alessandro Sionis) Cardiology Department. Parc Taulí Hospital Universitari. Sabadell, Spain. Parc Taulí, 1, 08208 Sabadell, Barcelona (Jordi Sans-Roselló).
| | - Maria Vidal-Burdeus
- Acute and Intensive Cardiovascular Care Unit, Department of Cardiology, Hospital Universitari Vall d’Hebrón. Barcelona, Spain
| | - Pablo Loma-Osorio
- Critical Cardiac Care Unit, Cardiology Department, Dr. Josep Trueta University Hospital, Girona, Spain
| | - Alexandra Pons Riverola
- Acute and Intensive Cardiovascular Care Unit, Department of Cardiology, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Gil Bonet Pineda
- Department of Cardiology, Joan XXIII University Hospital, Pere Virgili Health Research Institute (IISPV), Rovira i Virgili University, Tarragona, Spain
| | - Nabil El Ouaddi
- Acute and Intensive Cardiovascular Care Unit, Department of Cardiology, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Jaime Aboal
- Critical Cardiac Care Unit, Cardiology Department, Dr. Josep Trueta University Hospital, Girona, Spain
| | - Albert Ariza Solé
- Acute and Intensive Cardiovascular Care Unit, Department of Cardiology, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Claudia Scardino
- Department of Cardiology, Joan XXIII University Hospital, Pere Virgili Health Research Institute (IISPV), Rovira i Virgili University, Tarragona, Spain
| | - Cosme García-García
- Acute and Intensive Cardiovascular Care Unit, Department of Cardiology, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Estefanía Fernández-Peregrina
- Acute and Intensive Cardiovascular Care Unit, Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB-Sant Pau, Barcelona, Spain
| | - Alessandro Sionis
- Acute and Intensive Cardiovascular Care Unit, Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB-Sant Pau, Barcelona, Spain
- Corresponding autor at: Intensive Cardiac Care Unit. Cardiology Department. Hospital de la Santa Creu i Sant Pau, C/Santa Maria Claret 167, Barcelona 08025, Spain (Alessandro Sionis) Cardiology Department. Parc Taulí Hospital Universitari. Sabadell, Spain. Parc Taulí, 1, 08208 Sabadell, Barcelona (Jordi Sans-Roselló).
| |
Collapse
|
5
|
Mourão Carvalho N, Martins C, Cartaxo V, Marreiros A, Justo E, Raposo C, Binnie A. Out-of-hospital cardiac arrest in the Algarve region of Portugal: a retrospective registry trial with outcome data. Eur J Emerg Med 2022; 29:134-139. [PMID: 34775452 PMCID: PMC8865212 DOI: 10.1097/mej.0000000000000885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/19/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND IMPORTANCE Out-of-hospital cardiac arrest is a leading cause of death in Europe. An understanding of region-specific factors is essential for informing strategies to improve survival. DESIGN This retrospective observational study included all out-of-hospital cardiac arrest patients attended by the Emergency Medical Service of the Algarve in 2019. Outcome data were derived from hospital records. MAIN RESULTS In 2019, there were 850 out-of-hospital cardiac arrests treated with cardiopulmonary resuscitation in the Algarve, representing a population incidence of 189/100 000. Return of spontaneous circulation occurred in 83 patients (9.8%), of whom 17 (2.0%) had survival to hospital discharge and 15 (1.8%) had survival with good neurologic outcome. Among patients in the Utstein comparator group, survival to hospital discharge was 21.4%. Predictors of return of spontaneous circulation were age, witnessed arrest, initial shockable rhythm, time of year, time to cardiopulmonary resuscitation, and time to advanced life support. Predictors of survival to hospital discharge were age, initial shockable rhythm, time to rhythm analysis, and time to advanced life support. Predictors of survival with good neurologic outcome were age, initial shockable rhythm, and time to return of spontaneous circulation. CONCLUSIONS The incidence of out-of-hospital cardiac arrest with cardiopulmonary resuscitation in the Algarve was higher than in other jurisdictions while return of spontaneous circulation, survival to hospital discharge, and survival with good neurologic outcome were comparatively low. An aging population, a geographically diverse region, and a low incidence of bystander cardiopulmonary resuscitation may have contributed to these outcomes. These results confirm the importance of early cardiopulmonary resuscitation, early rhythm assessment, and early advanced life support, all of which are potentially modifiable through public education, broadening of the defibrillator network and increased availability of advanced life support teams.
Collapse
Affiliation(s)
- Nuno Mourão Carvalho
- Department of Intensive Care Medicine, Centro Hospitalar Universitário do Algarve
- Instituto Nacional de Emergência Médica
- Algarve Biomedical Centre Research Institute
- Faculty of Medicine and Biomedical Sciences, University of Algarve
| | - Cláudia Martins
- Faculty of Medicine and Biomedical Sciences, University of Algarve
| | | | - Ana Marreiros
- Faculty of Medicine and Biomedical Sciences, University of Algarve
| | | | - Carlos Raposo
- Department of Intensive Care Medicine, Centro Hospitalar Universitário do Algarve
- Instituto Nacional de Emergência Médica
- Department of Surgery, Centro Hospitalar Universitário do Algarve, Faro, Portugal
| | - Alexandra Binnie
- Algarve Biomedical Centre Research Institute
- Faculty of Medicine and Biomedical Sciences, University of Algarve
- Critical Care Department, William Osler Health System, Etobicoke, Ontario, Canada
| |
Collapse
|
6
|
Trends in out-of-hospital cardiac arrest incidence, patient characteristics and survival over 18 years in Perth, Western Australia. Resusc Plus 2022; 9:100201. [PMID: 35098176 PMCID: PMC8783140 DOI: 10.1016/j.resplu.2022.100201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/28/2021] [Accepted: 01/03/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives To investigate trends in the incidence, characteristics, and survival of out-of-hospital cardiac arrests (OHCA) in the Perth metropolitan area between 2001 and 2018. Methods We calculated the crude incidence rate, age-standardised incidence rate (ASIR) and age- and sex-specific incidence rates (per 100,000 population) for OHCA of presumed cardiac aetiology. ASIRs were calculated using the direct method of standardisation using the 2001 Australian Population standard. Survival was assessed at return of spontaneous circulation at emergency department arrival and at 30 days. Temporal trends in patient and arrest characteristics were assessed with logistic regression, while trends in incidence were assessed using Joinpoint regression. Survival trends were assessed using binary logistic regression. Results A total of 18,417 OHCAs of presumed cardiac aetiology were attended by emergency medical services in Perth between 2001 and 2018. Overall, there were no significant changes in the crude or ASIR of OHCA over the study period, although OHCA incidence in 15–39 year-old males increased by 12.5% annually between 2011 and 2018. Both bystander cardiopulmonary resuscitation and bystander defibrillation increased over the study period, while the proportion of shockable arrests declined. Thirty-day OHCA survival improved significantly over time, with the odds of survival (in bystander-witnessed, initial shockable rhythm arrests) improving 12% (95% CI, 9.0% to 14.0%) annually, from 8.4% in 2001 to 44.0% in 2018. Conclusion Overall, there were no significant trends in OHCA incidence over the study period, although arrests in 15–39 year-old males increased significantly after 2011. There were significant improvements in 30-day survival between 2001 and 2018.
Collapse
|
7
|
Desai R, Jain A, Dhaduk K, Chhina AK, Raina J, Itare V, Kumar G, Sachdeva R. Mortality in young adults following out-of-hospital cardiac arrest: Evidence from two nationwide propensity-matched cohorts in the United States a decade apart. IJC HEART & VASCULATURE 2022; 38:100937. [PMID: 35036517 PMCID: PMC8749059 DOI: 10.1016/j.ijcha.2021.100937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Rupak Desai
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA, USA
| | - Akhil Jain
- Internal Medicine, Mercy Catholic Medical Center, Darby, PA, USA
| | - Kartik Dhaduk
- Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes Barre, PA, USA
| | | | - Jilmil Raina
- Department of Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Vikram Itare
- Department of Internal Medicine, BronxCare Health System, Bronx, NY, USA
| | - Gautam Kumar
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA, USA.,Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Rajesh Sachdeva
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA, USA
| |
Collapse
|
8
|
Darvall JN, Morley P. How frail the human heart? Resuscitation 2021; 167:383-384. [PMID: 34474144 DOI: 10.1016/j.resuscitation.2021.08.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Jai N Darvall
- Department of Critical Care, The University of Melbourne, Melbourne, Australia; Royal Melbourne Hospital Clinical School, The University of Melbourne, Melbourne, Australia.
| | - Peter Morley
- Royal Melbourne Hospital Clinical School, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
9
|
Kranc H, Novack V, Shtein A, Sherman R, Novack L. Extreme temperature and out-of-hospital-cardiac-arrest. Nationwide study in a hot climate country. Environ Health 2021; 20:38. [PMID: 33820550 PMCID: PMC8022396 DOI: 10.1186/s12940-021-00722-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 03/17/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND Out-of-hospital-cardiac arrest (OHCA) is frequently linked to environmental exposures. Climate change and global warming phenomenon have been found related to cardiovascular morbidity, however there is no agreement on their impact on OHCA occurrence. In this nationwide analysis, we aimed to assess the incidence of the OHCA events attended by emergency medical services (EMS), in relation to meteorological conditions: temperature, humidity, heat index and solar radiation. METHODS We analyzed all adult cases of OHCA in Israel attended by EMS during 2016-2017. In the case-crossover design, we compared ambient exposure within 72 h prior to the OHCA event with exposure prior to the four control times using conditional logistic regression in a lag-distributed non-linear model. RESULTS There were 12,401 OHCA cases (68.3% were pronounced dead-on-scene). The patients were on average 75.5 ± 16.2 years old and 55.8% of them were males. Exposure to 90th and 10th percentile of temperature adjusted to humidity were positively associated with the OHCA with borderline significance (Odds Ratio (OR) =1.20, 95%CI 0.97; 1.49 and OR 1.16, 95%CI 0.95; 1.41, respectively). Relative humidity below the 10th percentile was a risk factor for OHCA, independent of temperature, with borderline significance (OR = 1.16, 95%CI 0.96; 1.38). Analysis stratified by seasons revealed an adverse effect of exposure to 90th percentile of temperature when estimated in summer (OR = 3.34, 95%CI 1.90; 3.5.86) and exposure to temperatures below 10th percentile in winter (OR = 1.75, 95%CI 1.23; 2.49). Low temperatures during a warm season and high temperatures during a cold season had a protective effect on OHCA. The heat index followed a similar pattern, where an adverse effect was demonstrated for extreme levels of exposure. CONCLUSIONS Evolving climate conditions characterized by excessive heat and low humidity represent risk factors for OHCA. As these conditions are easily avoided, by air conditioning and behavioral restrictions, necessary prevention measures are warranted.
Collapse
Affiliation(s)
- Hannan Kranc
- Department of Public Health, Faculty of Health Sciences, School of Medicine, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Victor Novack
- Clinical Research Center, Soroka University Medical Center, Beer Sheva, Israel
- Department of Internal Medicine, Soroka University Medical Center, Beer Sheva, Israel
| | - Alexandra Shtein
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | | | - Lena Novack
- Negev Environmental Health Research Institute, Soroka University Medical Center, 84101 Beer Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| |
Collapse
|