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https://www.readbyqxmd.com/read/28437201/the-impact-of-community-based-palliative-care-on-utilization-and-cost-of-acute-care-hospital-services-in-the-last-year-of-life
#1
David Youens, Rachael Moorin
BACKGROUND: Community-based palliative care may potentially benefit patients by offering their preferred care at the end of life and benefit systems by reducing hospital use. OBJECTIVE: To compare place of death and acute care hospital use in the last year of life between cancer decedents who did and did not access a community-based palliative care service (PCS). DESIGN: Retrospective observational cohort study using linked individual administrative records from cancer registry, hospital, emergency department (ED), mortality, and PCS databases...
February 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28436978/association-of-hematopoietic-cell-transplantation-specific-comorbidity-index-with-resource-utilization-after-allogeneic-transplantation
#2
L Decook, Y-H Chang, J Slack, D Gastineau, J Leis, P Noel, J Palmer, L Sproat, M Sorror, N Khera
Comorbidities affect clinical outcomes and costs in medicine. The hematopoietic cell transplantation (HCT)-specific comorbidity index (HCT-CI) predicts mortality risk after HCT. Its association with resource utilization (RU) is unknown. In this single-center, retrospective study, we examined the association of HCT-CI with RU (readmissions, length of hospital stay (LOS) and days out of hospital alive (DOHA)) in first 100 days (n=328) and 1 year (n=226) in allogeneic HCT patients from January 2010 to June 2014...
April 24, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28432023/pulmonary-embolism-related-sudden-cardiac-arrest-admitted-alive-at-hospital-management-and-outcomes
#3
Wulfran Bougouin, Eloi Marijon, Benjamin Planquette, Nicole Karam, Florence Dumas, David S Celermajer, Daniel Jost, Lionel Lamhaut, Frankie Beganton, Alain Cariou, Guy Meyer, Xavier Jouven
AIM: Pulmonary Embolism (PE) is a relatively common cardiovascular condition, occasionally and tragically manifesting as Sudden Cardiac Arrest (SCA). The natural history of SCA complicating PE has been poorly evaluated.In this study, we described the management and outcome of PE-related SCA. METHODS: In this prospective population-based study, we included all patients admitted at hospital alive after out-of- hospital SCA, in Paris and suburbs, France (6.6 million inhabits), from May 2011 to September 2015...
April 18, 2017: Resuscitation
https://www.readbyqxmd.com/read/28431508/association-between-cardiopulmonary-resuscitation-duration-and-one-month-neurological-outcomes-for-out-of-hospital-cardiac-arrest-a-prospective-cohort-study
#4
Masahiro Kashiura, Yuichi Hamabe, Akiko Akashi, Atsushi Sakurai, Yoshio Tahara, Naohiro Yonemoto, Ken Nagao, Arino Yaguchi, Naoto Morimura
BACKGROUND: The duration of cardiopulmonary resuscitation (CPR) is an important factor associated with the outcomes for an out-of-hospital cardiac arrest. However, the appropriate CPR duration remains unclear considering pre- and in-hospital settings. The present study aimed to evaluate the relationship between the CPR duration (including both the pre- and in-hospital duration) and neurologically favorable outcomes 1-month after cardiac arrest. METHODS: Data were utilized from a prospective multi-center cohort study of out-of-hospital cardiac arrest patients transported to 67 emergency hospitals between January 2012 and March 2013 in the Kanto area of Japan...
April 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28429693/predictors-of-neurologically-favorable-survival-among-patients-with-out-of-hospital-cardiac-arrest-a-tertiary-referral-hospital-experience
#5
Kevser Gülcihan Balcı, Mustafa Mücahit Balcı, Fatih Şen, Mehmet Kadri Akboğa, Erol Kalender, Samet Yılmaz, Orhan Maden, Hatice Selçuk, Timur Selçuk, Ahmet Temizhan
OBJECTIVE: Despite recent advances in medical support and interventions, only 5% to 10% of patients with out-of-hospital cardiac arrest (OHCA) survive to discharge. In this study, factors related to neurologically favorable survival in patients with OHCA were analyzed. METHODS: A total of 129 patients who were admitted to hospital with OHCA were retrospectively enrolled. RESULTS: Sustained return of spontaneous circulation (ROSC) (ROSC lasting >20 min) was achieved in 29 (22...
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28427882/effects-of-bystander-cpr-following-out-of-hospital-cardiac-arrest-on-hospital-costs-and-long-term-survival
#6
Guillaume Geri, Carol Fahrenbruch, Hendrika Meischke, Ian Painter, Lindsay White, Thomas D Rea, Marcia R Weaver
BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) is associated with a greater likelihood of survival to hospital discharge after out-of-hospital cardiac arrest (OHCA). However the long-term survival benefits in relationship to cost have not been well-studied. We evaluated bystander CPR, hospital-based costs, and long-term survival following OHCA in order to assess the potential cost-effectiveness of bystander CPR. PATIENTS AND METHODS: We conducted a retrospective cohort study of consecutive EMS-treated OHCA patients >=12years who arrested prior to EMS arrival and outside a nursing facility between 2001 and 2010 in greater King County, WA...
April 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28427881/association-of-time-from-arrest-to-percutaneous-coronary-intervention-with-survival-outcomes-after-out-of-hospital-cardiac-arrest
#7
Joo Jeong, Young Sun Ro, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong, Ki Ok Ahn
BACKGROUND: Timely post-resuscitation coronary reperfusion therapy is recommended; however, the timing of immediate coronary reperfusion for out-of-hospital cardiac arrest (OHCA) has not been established. We studied the effect of the time interval from arrest to percutaneous coronary intervention (PCI) on resuscitated OHCA patients. METHODS: All witnessed OHCA patients with a presumed cardiac etiology received successful PCI at hospitals between 2013 and 2015, excluding cases with unknown information regarding the time from arrest to PCI and survival outcomes...
April 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28426467/neuron-specific-enolase-predicts-poor-outcome-after-cardiac-arrest-and-targeted-temperature-management-a-multicenter-study-on-1-053-patients
#8
Kaspar Josche Streitberger, Christoph Leithner, Michael Wattenberg, Peter H Tonner, Julia Hasslacher, Michael Joannidis, Tommaso Pellis, Elena Di Luca, Markus Födisch, Alexander Krannich, Christoph J Ploner, Christian Storm
OBJECTIVE: Outcome prediction after cardiac arrest is important to decide on continuation or withdrawal of intensive care. Neuron-specific enolase is an easily available, observer-independent prognostic biomarker. Recent studies have yielded conflicting results on its prognostic value after targeted temperature management. DESIGN, SETTING, AND PATIENTS: We analyzed neuron-specific enolase serum concentrations 3 days after nontraumatic in-hospital cardiac arrest and out-of-hospital cardiac arrest and outcome of patients from five hospitals in Germany, Austria, and Italy...
April 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28426258/improvements-in-out-of-hospital-cardiac-arrest-survival-from-1998-to-2013
#9
Yutaka Yamaguchi, Jeff A Woodin, Koichiro Gibo, Dana M Zive, Mohamud R Daya
OBJECTIVES: Out-of-hospital cardiac arrest (OHCA) remains a major public health burden. Aggregate OHCA survival to hospital discharge has reportedly remained unchanged at 7.6% for almost 30 years from 1970 to 2008. We examined the trends in adult OHCA survival over a 16-year period from 1998 to 2013 within a single EMS agency. METHODS: Observational cohort study of adult OHCA patients treated by Tualatin Valley Fire & Rescue (TVF&R) from 1998 to 2013. This is an ALS first response fire agency that maintains an active Utstein style cardiac arrest registry and serves a population of approximately 450,000 in 9 incorporated cities in Oregon...
April 20, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28424804/acute-medicine-finishing-school-preparing-for-the-next-step
#10
Tehmeena Khan, Nicholas Murch
The transition from registrar to consultant in medicine is one that trainees feel ill prepared for and can be extremely stressful. We devised the concept of an Acute Medicine "Finishing School" for senior trainees in London training programmes and ran sessions on CV writing, a simulated consultant interview, consultant job planning, responding to complaints and an out of hospital emergency scenario. Our feedback survey indicated that our delegates' confidence levels in all of the above aspects increased following the sessions...
2017: Acute Medicine
https://www.readbyqxmd.com/read/28422540/evaluating-barriers-to-bystander-cpr-among-laypersons-before-and-after-compression-only-cpr-training
#11
Andrew J Bouland, Megan H Halliday, Angela C Comer, Matthew J Levy, Kevin G Seaman, Benjamin J Lawner
OBJECTIVE: Bystander CPR is an essential part of out-of-hospital cardiac arrest (OHCA) survival. EMS and public safety jurisdictions have embraced initiatives to teach compression-only CPR to laypersons in order to increase rates of bystander CPR. We examined barriers to bystander CPR amongst laypersons participating in community compression-only CPR training and the ability of the training to alleviate these barriers. The barriers analyzed include fear of litigation, risk of disease transmission, fear of hurting someone as a result of doing CPR when unnecessary, and fear of hurting someone as a result of doing CPR incorrectly...
April 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28420118/ambient-air-pollution-and-out-of-hospital-cardiac-arrest-in-beijing-china
#12
Ruixue Xia, Guopeng Zhou, Tong Zhu, Xueying Li, Guangfa Wang
Air pollutants are associated with cardiovascular death; however, there is limited evidence of the effects of different pollutants on out-of-hospital cardiac arrests (OHCAs) in Beijing, China. We aimed to investigate the associations of OHCAs with the air pollutants PM2.5-10 (coarse particulate matter), PM2.5 (particles ≤2.5 μm in aerodynamic diameter), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), carbon monoxide (CO), and ozone (O₃) between 2013 and 2015 using a time-stratified case-crossover study design...
April 14, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28418553/patients-with-out-of-hospital-cardiac-arrest-with-no-chance-of-survival-and-consideration-for-organ-donation
#13
Joséphine Escutnaire, Hervé Hubert, Pierre-Yves Dubien, Pierre-Yves Gueugniaud
No abstract text is available yet for this article.
April 18, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28418552/patients-with-out-of-hospital-cardiac-arrest-with-no-chance-of-survival-and-consideration-for-organ-donation
#14
Nicole Karam, Patricia Jabre, Florence Dumas, Alain Cariou, Xavier Jouven
No abstract text is available yet for this article.
April 18, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28416430/-extracorporeal-membrane-oxygenation-in-critically-ill-neonates-and-children
#15
J Rambaud, J Guilbert, I Guellec, S Jean, A Durandy, M Demoulin, A Amblard, R Carbajal, P-L Leger
Extracorporeal membrane oxygenation is used as a last resort during neonatal and pediatric resuscitation in case of refractory circulatory or respiratory failure under maximum conventional therapies. Different types of ECMO can be used depending on the initial failure. The main indications for ECMO are refractory respiratory failure (acute respiratory distress syndrome, status asthmaticus, severe pneumonia, meconium aspiration syndrome, pulmonary hypertension) and refractory circulatory failure (cardiogenic shock, septic shock, refractory cardiac arrest)...
April 14, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28414165/recognising-out-of-hospital-cardiac-arrest-during-emergency-calls-increases-bystander-cardiopulmonary-resuscitation-and-survival
#16
Søren Viereck, Thea Palsgaard Møller, Annette Kjær Ersbøll, Josefine Stokholm Bækgaard, Andreas Claesson, Jacob Hollenberg, Fredrik Folke, Freddy K Lippert
BACKGROUND: Initiation of early bystander cardiopulmonary resuscitation (CPR) depends on bystanders' or medical dispatchers' recognition of out-of-hospital cardiac arrest (OHCA). The primary aim of our study was to investigate if OHCA recognition during the emergency call was associated with bystander CPR, return of spontaneous circulation (ROSC), and 30-day survival. Our secondary aim was to identify patient-, setting-, and dispatcher-related predictors of OHCA recognition. METHODS: We performed an observational study of all OHCA patients' emergency calls in the Capital Region of Denmark from 01/01/2013-31/12/2013...
April 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28414164/a-pre-hospital-extracorporeal-cardio-pulmonary-resuscitation-ecpr-strategy-for-treatment-of-refractory-out-hospital-cardiac-arrest-an-observational-study-and-propensity-analysis
#17
Lionel Lamhaut, Alice Hutin, Etienne Puymirat, Jérome Jouan, Jean-Herlé Raphalen, Romain Jouffroy, Murielle Jaffry, Christelle Dagron, Kim An, Florence Dumas, Eloi Marijon, Wulfran Bougouin, Jean-Pierre Tourtier, Frédéric Baud, Xavier Jouven, Nicolas Danchin, Christian Spaulding, Pierre Carli
BACKGROUND: Out of hospital cardiac arrest (OHCA) mortality rates remain very high with poor neurological outcome in survivors. Extracorporeal cardiopulmonary resuscitation (ECPR) is one of the treatments of refractory OHCA. This study used data from the mobile intensive care unit (MOICU) as part of the emergency medical system of Paris, and included all consecutive patients treated with ECPR (including pre-hospital ECPR) from 2011 to 2015 for the treatment of refractory OHCA, comparing two historical ECPR management strategies...
April 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28413515/outcome-of-out-of-hospital-cardiac-arrest-after-fibrinolysis-with-reteplase-in-comparison-to-the-return-of-spontaneous-circulation-after-cardiac-arrest-score-in-a-geographic-region-without-emergency-coronary-intervention
#18
Thomas Luiz, Alexander Wilhelms, Christian Madler, Gregor Pollach, Bernd Haaff, Joachim Grüttner, Tim Viergutz
Coronary occlusion and pulmonary embolism are responsible for the majority of cases of out-of-hospital cardiac arrest (OHCA). Despite previous favourable results of pre-hospital fibrinolysis in cases of OHCA, the benefit could not be confirmed in a large controlled study using the fibrinolytic tenecteplase. For reteplase (r-PA), there are hardly any data regarding pre-hospital fibrinolysis during ongoing resuscitation. The present study reported results using r-PA therapy in a German physician-supported Emergency Medical Services system...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28411927/out-of-hospital-evaluation-and-treatment-of-accidental-hypothermia
#19
REVIEW
Ken Zafren
Accidental hypothermia is an unintentional drop in core temperature to 35°C or below. Core temperature is best measured by esophageal probe. If core temperature cannot be measured, the degree should be estimated using clinical signs. Treatment is to protect from further heat loss, minimize afterdrop, and prevent cardiovascular collapse during rescue and resuscitation. The patient should be handled gently, kept horizontal, insulated, and actively rewarmed. Active rewarming is also beneficial in mild hypothermia but passive rewarming usually suffices...
May 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28410590/early-predictors-of-poor-outcome-after-out-of-hospital-cardiac-arrest
#20
Louise Martinell, Niklas Nielsen, Johan Herlitz, Thomas Karlsson, Janneke Horn, Matt P Wise, Johan Undén, Christian Rylander
BACKGROUND: Early identification of predictors for a poor long-term outcome in patients who survive the initial phase of out-of-hospital cardiac arrest (OHCA) may facilitate future clinical research, the process of care and information provided to relatives. The aim of this study was to determine the association between variables available from the patient's history and status at intensive care admission with outcome in unconscious survivors of OHCA. METHODS: Using the cohort of the Target Temperature Management trial, we performed a post hoc analysis of 933 unconscious patients with OHCA of presumed cardiac cause who had a complete 6-month follow-up...
April 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
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