The Impact of Cardiopulmonary Resuscitation Guidelines Updates Against Out-of-Hospital Shockable Cardiac Arrest: A Population-Based Cohort Study

2021 ◽  
Author(s):  
Ken Nagao ◽  
Naohiro Yonemoto ◽  
David F. Gaieski ◽  
Tsukasa Yagi ◽  
Eizo Tachibana, ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cohort Study ◽  
Cardiopulmonary Resuscitation ◽  
Population Based ◽  
Resuscitation Guidelines ◽  
The Impact ◽  
Cardiopulmonary Resuscitation Guidelines

scholarly journals End-Of-Life Discussions Reduce The Utilization of Life-Sustaining Treatments During The Last Three Months of Life in Cancer Patients : A Nationwide Population-Based Cohort Study

2021 ◽  
Author(s):  
Shang-Yih Chan ◽  
Yun-Ju Lai ◽  
Yu-Yen Hsin Chen ◽  
Shuo-Ju Chiang ◽  
Yi-Fan Tsai ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cardiopulmonary Resuscitation ◽  
End Of Life ◽  
Cancer Patients ◽  
Medical Records ◽  
Population Based ◽  
Lower Likelihood ◽  
The Mean ◽  
The Impact ◽  
To Receive

Abstract Purpose Studies to examine the impact of end-of-life (EOL) discussions on the utilization of life-sustaining treatments near death were limited and had inconsistent findings. This nationwide population-based cohort study determined the impact of EOL discussions on the utilization of life-sustaining treatments in the last three months of life in Taiwanese cancer patients. Methods This cohort study included adult cancer patients from 2012–2018, which were confirmed by pathohistological reports. Life-sustaining treatments during the last three months of life included cardiopulmonary resuscitation, intubation, and defibrillation. EOL discussions in cancer patients were confirmed by their medical records. Association of EOL discussions with utilization of life-sustaining treatments were assessed using multiple logistic regression. Results Of 381,207 patients, the mean age was 70.5 years and 19.4% of the subjects utilized life-sustaining treatments during the last three months of life. After adjusting for other covariates, those who underwent EOL discussions were less likely to receive life-sustaining treatments during the last three months of life compared to those who did not (Adjusted odds ratio [AOR]: 0.82; 95% confidence interval [CI]: 0.80–0.84). Considering the type of treatments, EOL discussions correlated with a lower likelihood of receiving cardiopulmonary resuscitation (AOR = 0.43, 95% CI: 0.41–0.45), endotracheal intubation (AOR = 0.87, 95%CI: 0.85–0.89), and defibrillation (AOR = 0.52, 95%CI: 0.48–0.57). Conclusion EOL discussions correlated with a lower utilization of life-sustaining treatments during the last three months of life among cancer patients. Our study supports the importance of providing these discussions to cancer patients to better align care with preferences during the EOL treatment.

scholarly journals Protocol for a cohort study of the impact of the COVID-19 pandemic on the rate and incidence of bystander cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Ingvild B. M. Tjelmeland ◽  
Jan Wnent ◽  
Siobhan Masterson ◽  
Jo Kramer-Johansen ◽  
Jan-Thorsten Gräsner
Keyword(s):  
Cardiac Arrest ◽  
Cohort Study ◽  
Cardiopulmonary Resuscitation ◽  
Early Recognition ◽  
Aggregated Data ◽  
General Data Protection Regulation ◽  
Number Of Patients ◽  
Bystander Cpr ◽  
The Impact ◽  
Hospital Cardiac Arrest

Abstract Background Survival after out-of-hospital cardiac arrest (OHCA) is dependent on early recognition, early cardiopulmonary resuscitation (CPR) and early defibrillation. The purpose of CPR is to maintain some blood flow until the arrival of the emergency medical services (EMS). Our concern is that the COVID-19 pandemic has had a negative effect on the number of patients who get CPR before EMS arrival. The aim of this study is to compare the incidence of bystander CPR during the pandemic with data from before the pandemic. Methods The protocol is for a retrospective cohort study where data from existing registries will be used. All participating registries will share aggregated data from 2017 to 2020, and the study team will compare the results from 2020 to results from 2017 to 2019. Due to the General Data Protection Regulation, each participating registry will check for completeness and plausibility, and perform all aggregation of data locally. In the following analysis different registries will be considered as random samples and analysed by means of a generalized linear mixed effects model with Poisson distribution for the outcome, the population covered as offsets, and different registries as random factors. Discussion This study does not present the prospect of direct benefit to the patient, but does provide an opportunity to gain a better understanding of the epidemiology of bystander CPR for OHCA patients during a pandemic. By comparing data during the pandemic with already collected information in established registries we believe we can gain valuable information about changes in public response to out-of-hospital cardiac arrest.

scholarly journals Cardiac arrest as a reportable condition: a cohort study of the first 6 years of the Norwegian out-of-hospital cardiac arrest registry

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e038133
Author(s):  
Ingvild Beathe Myrhaugen Tjelmeland ◽  
Kristin Alm-Kruse ◽  
Lars-Jøran Andersson ◽  
Ståle Bratland ◽  
Arne-Ketil Hafstad ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cohort Study ◽  
Cardiopulmonary Resuscitation ◽  
Population Based ◽  
National Registry ◽  
Secondary Outcome ◽  
Public Employees ◽  
Unique Identifier ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Inclusion Rate

ObjectivesThe Norwegian Cardiac Arrest Registry (NorCAR) was established in 2013 when cardiac arrest became a mandatory reportable condition. The aim of this cohort study is to describe how the world’s first mandatory, population-based cardiac arrest registry evolved during its first 6 years.SettingNorway has a total population of 5.3 million inhabitants with a population density that varies considerably. All residents are assigned a unique identifier number, giving nationally approved registries access to information about all births and deaths in the country. Data in the registry are entered by data processors; public employees with close links to the emergency medical services. All data processors undergo a standardised training and meet for yearly retraining and updates.ParticipantsAll events of cardiac arrest where bystanders or healthcare professionals have started cardiopulmonary resuscitation or performed defibrillation are included into the NorCAR.Primary and secondary outcome measuresSince the establishment of the registry, the number of reporting health trusts, the number of reported events and the corresponding population at risk were followed year by year. Outcome is measured as changes in inclusion rate, incidence per 100 000 inhabitants and survival to 30 days after cardiac arrest.ResultsIn total, 14 849 cases were registered over 6 years, between 2013 and 2018. The number of health trusts reporting rose steadily from 2013. Within 3 years, all trusts reported to the registry with an increasing number of events reported; going from 1101 to 3400 per year. The prevalence of bystander cardiopulmonary resuscitation increased slightly, but the population incidence of survival did not change.ConclusionDeclaring cardiac arrest as a reportable condition and close follow-up of all reporting areas is essential when building a national registry.

Nationwide survival after inhospital cardiac arrest before and after 2010 cardiopulmonary resuscitation guidelines: 2007–2014

2017 ◽  
Vol 249 ◽  
pp. 231-233 ◽  
Author(s):  
Sagar Mallikethi-Reddy ◽  
Emmanuel Akintoye ◽  
Melvyn Rubenfire ◽  
Alexandros Briasoulis ◽  
Cindy L. Grines ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Resuscitation Guidelines ◽  
Before And After ◽  
Cardiopulmonary Resuscitation Guidelines
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