Journal of the American Heart Association
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Observational Study
Outcomes of out-of-hospital cardiac arrest by public location in the public-access defibrillation era.
The strategy to place public-access automated external defibrillators (AEDs) has not yet been established in real settings. ⋯ This large, population-based OHCA registry demonstrated that earlier shock, irrespective the shock provider (bystander or EMS personnel), contributed to improving outcome, and a public-access defibrillation program was successfully implemented so that shocks with public-access AEDs were delivered to over 40% of bystander-witnessed OHCAs and time to shock was shortened in some kinds of public places.
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Multicenter Study Comparative Study
Sensitivity, specificity, and sex differences in symptoms reported on the 13-item acute coronary syndrome checklist.
Clinical symptoms are part of the risk stratification approaches used in the emergency department (ED) to evaluate patients with suspected acute coronary syndromes (ACS). The objective of this study was to determine the sensitivity, specificity, and predictive value of 13 symptoms for a discharge diagnosis of ACS in women and men. ⋯ There were more similarities than differences in symptom predictors of ACS for women and men.
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Comparative Study
Efficacy of chest compressions directed by end-tidal CO2 feedback in a pediatric resuscitation model of basic life support.
End-tidal carbon dioxide (ETCO2) correlates with systemic blood flow and resuscitation rate during cardiopulmonary resuscitation (CPR) and may potentially direct chest compression performance. We compared ETCO2-directed chest compressions with chest compressions optimized to pediatric basic life support guidelines in an infant swine model to determine the effect on rate of return of spontaneous circulation (ROSC). ⋯ The use of ETCO2-directed chest compressions is a novel guided approach to resuscitation that can be as effective as standard CPR optimized with marker, video, and verbal feedback.
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Comparative Study
Gender-specific risk factors for peripheral artery disease in a voluntary screening population.
Women have high rates of peripheral artery disease (PAD) despite fewer cardiovascular disease (CVD) risk factors, compared to men. We sought to determine the gender-specific prevalence of low ankle brachial index (ABI) and the relationship to C-reactive protein (CRP) levels and CVD risk factors in the Life Line Screening population. ⋯ Women participating in the Life Line Screening had higher CRP levels and a higher prevalence of PAD, compared to men. Neither higher CRP levels nor conventional CVD risk factors explained the excess prevalence of PAD in women.
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Multicenter Study Comparative Study
Hospital variation in survival after in-hospital cardiac arrest.
In-hospital cardiac arrest (IHCA) is common and often fatal. However, the extent to which hospitals vary in survival outcomes and the degree to which this variation is explained by patient and hospital factors is unknown. ⋯ Significant variability in IHCA survival exists across hospitals, and this variation persists despite adjustment for measured patient factors and within hospital subgroups. These findings suggest that other hospital factors may account for the observed site-level variations in IHCA survival.