Resuscitation
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Multicenter Study
Regional trends in In-hospital Cardiac Arrest following sepsis-related admissions and subsequent mortality.
Previous studies have reported regional variation in either the incidence or outcomes of sepsis or In-hospital Cardiac Arrest (IHCA) discretely; however, regional variations in the incidence and outcomes of sepsis-associated IHCA (SA-IHCA) have never been studied. ⋯ This nationwide analysis demonstrates that the highest incidence of SA-IHCA is in the Southern region of the US whereas the associated in-hospital mortality was highest in the West. The incidence of SA-IHCA is rising in the Midwest and South from 2007 to 2014. Despite significant advances in the treatment of sepsis and IHCA, there has been no significant improvement in the incidence of SA-IHCA and subsequent survival in any US geographic region from 2007 to 2014.
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Multicenter Study
Neonates with a 10-min Apgar score of zero: Outcomes by gestational age.
The current resuscitation guidelines for neonates recommend considering stopping resuscitation efforts if the heart rate remains undetectable after 10 min of adequate resuscitation. However, this recommendation does not take into account the gestational age (GA) of the neonates. We determined the outcomes of neonates with a 10-min Apgar score of zero (Apgar10 = 0) with respect to their GA. ⋯ Neonates with Apgar10 = 0 had different outcomes depending on their GA. Less than half of neonates born at <32 weeks GA survived; however, a majority of neonates born at 320/7-356/7 weeks' and ≥36 weeks' GA survived at similar rates than their matched neonates with Apgar10 = 1-2.
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We investigated the impact of gender in performance and findings of early coronary angiography (CAG) and percutaneous coronary intervention (PCI), comorbidity and outcome in a large population of out-of-hospital cardiac arrest (OHCA) patients with an initially shockable rhythm. ⋯ Despite no gender differences in ECG findings indicating an early CAG, men had more severe coronary artery disease while women more frequently had normal coronary angiography. However, this did not influence 1-year survival.
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Multicenter Study
Out-of-hospital cardiac arrest in patients with psychiatric disorders - Characteristics and outcomes.
To investigate whether the recent improvements in pre-hospital cardiac arrest-management and survival following out-of-hospital cardiac arrest (OHCA) also apply to OHCA patients with psychiatric disorders. ⋯ Patients with psychiatric disorders have lower survival following OHCA compared to non-psychiatric patients and the gap between the two groups has widened over time.
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Multicenter Study Observational Study
Out of hospital cardiac arrest outcomes: Impact of weekdays vs weekends admission on survival to hospital discharge.
Cardiac arrests are a leading cause of mortality with survival of only 12%. In the United States, cardiac arrests were significantly more likely to occur on Saturdays. Hospitals experience a decrease in staffing on weekends. This study aims to assess the relationship between weekend vs weekday admission and outcomes of patients presenting with out of hospital cardiac arrests (OHCA) in the United States. ⋯ In this study, patients with OHCA admitted to the ED on weekends had slightly lower survival compared to those admitted on weekdays. Modifiable factors should be identified in future studies to reduce outcome discrepancies and improve survival in this patient population.