Resuscitation
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Lower survival chances after out-of-hospital cardiac arrest (OHCA) in women is associated with lower odds of a shockable initial rhythm (SIR). We hypothesized that sex differences in the prevalence of SIR are due to sex differences in comorbidities. We aimed to establish to what extent sex differences in the cumulative comorbidity burden, measured using the Charlson Comorbidity Index (CCI), or in individual comorbidities, account for the lower proportion of SIR in women. ⋯ Sex differences in comorbidities explained lower odds of SIR in women only modestly: differences in previous myocardial infarction contributed little, and cumulative comorbidity not at all.
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Editorial Comment
More evidence of health inequalities in cardiac arrest outcomes.
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Review Meta Analysis
Prognostic Association of Frailty with Post-Arrest Outcomes Following Cardiac Arrest: A Systematic Review and Meta-Analysis.
To synthesize the current evidence examining the association between frailty and a series of post-arrest outcomes following the provision of cardiopulmonary resuscitation (CPR). ⋯ High certainty evidence was found for an association between frailty and in-hospital mortality following IHCA. Frailty is a robust prognostic factor that contributes valuable information and can inform shared-decision making and policies surrounding advance care directives. Registration: PROSPERO Registration # CRD42020212922.
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Recent reports have questioned the efficacy of intraosseous (IO) drug administration for out-of-hospital cardiac arrest (OHCA) resuscitation. Our aim was to determine whether prehospital administration of resuscitative medications via the IO route was associated with lower rates of return of spontaneous circulation (ROSC) and survival to hospital discharge than peripheral intravenous (IV) infusion in the setting of OHCA. ⋯ In this cohort of OHCA patients, the use of prehospital IO drug administration was associated with unfavorable clinical outcomes.