Resuscitation
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Associations between neighbourhood environments and survival outcomes after out-of-hospital cardiac arrests (OHCAs) have been proposed. The purpose of this study was to examine the association between county-level cardiopulmonary resuscitation (CPR) training rates and improvements in survival outcomes after OHCA over 5 years. ⋯ There were moderate associations between county-level CPR training and improvements in good neurological recovery rates over 5 years in the counties.
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To assess the performance of neuroprognostic guidelines proposed by the American Academy of Neurology (AAN), European Resuscitation Council/European Society of Intensive Care Medicine (ERC/ESICM), and American Heart Association (AHA) in predicting outcomes of patients who remain unconscious after cardiac arrest. ⋯ Though each guideline had components that performed well, only the ERC/ESICM guideline yielded a 0% FPR. Amongst the AAN and AHA guidelines, false positives emerged more readily at 6 months, reflective of continuing recovery after discharge, even in a cohort inevitably biased by WLST. Further assessment of predictive modalities is needed to improve neuroprognostic accuracy.
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We evaluated the impact of patient age and time from collapse to return of spontaneous circulation (ROSC) on the prognostic accuracy of neuron specific enolase (NSE) after out-of-hospital cardiac arrest (OHCA). ⋯ NSE at 48 h after OHCA is a useful predictor of 12-month-prognosis in young patients and in patients with a long time from collapse to ROSC, but not in old patients or patients with a short time to ROSC.
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Data pertaining to clinical characteristics and outcomes of cardiac arrest (CA) due to drug overdose (ODCA) are limited. We hypothesized that patients with ODCA would have binary outcomes (brain death or functional recovery) compared to patients in whom CA was due to another etiology. ⋯ Despite similar neurological recovery and survival rates to hospital discharge, ODCA patients were more likely than non-ODCA patients to progress to brain death. Larger prospective studies analyzing ODCA are needed to better understand potential treatment options and prognostic tools in this cohort.
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Observational Study
Exercise-related out-of-hospital cardiac arrest in Victoria, Australia.
Characteristics and outcomes of exercise-related out-of-hospital cardiac arrests (OHCA) are not well described in Australia. ⋯ Exercise-related OHCAs were associated with better short- and long-term prognoses compared to non-exercise-related OHCAs. The underlying factors associated with this survival benefit warrant further investigation.