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https://www.readbyqxmd.com/read/29131479/measuring-the-success-of-medical-emergency-teams-potentially-preventable-deaths-versus-total-cardiac-arrest-deaths-a-single-centre-observational-study
#1
Jonathan Barrett, Gabrielle Hawdon, Julie Wade, John Reeves
Measuring the success of Medical Emergency Teams: Potentially preventable deaths versus total cardiac arrest deaths. A single centre observational study. BACKGROUND: Rapid response systems (RRS) have been implemented with the aim of preventing patient deterioration, in-hospital cardiac arrests (IHCA) and related deaths. Not all "unexpected deaths" are preventable, thus compromising the use of unexpected deaths as an outcome measure. AIMS: Our aim was to assess temporal trends in potentially preventable deaths as a subset of total unexpected death rates over a four-year period...
November 13, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29129250/temporal-trends-and-hospital-level-variation-of-inhospital-cardiac-arrest-incidence-and-outcomes-in-the-veterans-health-administration
#2
Steven M Bradley, Peter Kaboli, Lee A Kamphuis, Paul S Chan, Theodore J Iwashyna, Brahmajee K Nallamothu
BACKGROUND: Despite significant attention to resuscitation care by hospitals, national data on trends in the incidence and survival of patients with inhospital cardiac arrest (IHCA) are limited. OBJECTIVE: To determine trends and hospital-level variation in the incidence and outcomes associated with IHCA. In exploratory analyses, we evaluated the relationship between hospital-level IHCA incidence and outcomes with general hospital-wide quality improvement activities...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29116359/use-of-automated-external-defibrillators-for-in-hospital-cardiac-arrest-any-time-any-place
#3
A Wutzler, C Kloppe, A K Bilgard, A Mügge, C Hanefeld
BACKGROUND: Acute treatment of in-hospital cardiac arrest (IHCA) is challenging and overall survival rates are low. However, data on the use of public-access automated external defibrillators (AEDs) for IHCA remain controversial. The aim of our study was to evaluate characteristics of patients experiencing IHCA and feasibility of public-access AED use for resuscitation in a university hospital. METHODS: IHCA events outside the intensive care unit were analysed over a period of 21 months...
November 7, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29102470/long-term-survival-trends-of-medicare-patients-after-in-hospital-cardiac-arrest-insights-from-get-with-the-guidelines-resuscitation-%C3%A2
#4
Lauren E Thompson, Paul S Chan, Fengming Tang, Brahmajee K Nallamothu, Saket Girotra, Sarah M Perman, Somnath Bose, Stacie L Daugherty, Steven M Bradley
BACKGROUND: Although rates of survival to hospital discharge after in-hospital cardiac arrest (IHCA) have improved over the last decade, it is unknown if these survival gains are sustained after hospital discharge. OBJECTIVE: To examine 1-year survival trends overall and by rhythm after IHCA. METHODS: Using Medicare beneficiaries (age≥65years) with IHCA occurring between 2000 and 2011 at Get With The Guidelines®-Resuscitation Registry participating hospitals we used multivariable regression, to examine temporal trends in risk-adjusted rates of 1-year survival...
November 1, 2017: Resuscitation
https://www.readbyqxmd.com/read/29049132/one-year-survival-after-in-hospital-cardiac-arrest-does-pre-arrest-sepsis-matter
#5
Pia Koivikko, Olli Arola, Outi Inkinen, Minna Tallgren
AIM: Cardiac arrest is not a common complication of sepsis, although sepsis has been recognized as one condition behind cardiac arrest. Our aim was to evaluate the prevalence of sepsis among patients with in-hospital cardiac arrest (IHCA), and to determine if sepsis is associated with inferior outcome after IHCA. METHODS: All consecutive emergency team dispatches in Turku University Hospital in 2011-2014 (n = 607) were reviewed retrospectively to identify the patients undergoing cardiopulmonary resuscitation (CPR) for IHCA (n = 301)...
October 18, 2017: Shock
https://www.readbyqxmd.com/read/29040883/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-for-emergency-cardiac-support
#6
Terri Sun, Andrew Guy, Amandeep Sidhu, Gordon Finlayson, Brian Grunau, Lillian Ding, Saida Harle, Leith Dewar, Richard Cook, Hussein D Kanji
PURPOSE: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may provide benefit to patients in refractory cardiac arrest and cardiogenic shock. We aim to summarize our center's 6-year experience with resuscitative VA-ECMO. MATERIALS AND METHODS: A retrospective medical record review (April 2009 to 2015) was performed on consecutive non-cardiotomy patients who were managed with VA-ECMO due to refractory in- or out-of-hospital cardiac (IHCA/OHCA) arrest (E-CPR) or refractory cardiogenic shock (E-CS) with or without preceding cardiac arrest...
October 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29031624/impact-of-timing-of-cardiac-arrest-during-hospitalization-on-survival-outcomes-and-subsequent-length-of-stay
#7
Abdul H Qazi, Kevin Kennedy, Steven M Bradley, Paul S Chan
BACKGROUND: In-hospital cardiac arrest (IHCA) is common and often fatal. However, the association between timing of cardiac arrest and likelihood of survival to discharge, neurological status, and subsequent hospital length of stay (LOS) is unknown. METHODS: Within the Get-With-The-Guidelines Resuscitation registry, we identified 175,904 patients between 2000 and 2014 with an IHCA. Time from admission to IHCA was categorized as <3, 3-7, or >7days from admission...
October 13, 2017: Resuscitation
https://www.readbyqxmd.com/read/29020604/predictors-of-favourable-outcome-after-in-hospital-cardiac-arrest-treated-with-extracorporeal-cardiopulmonary-resuscitation-a-systematic-review-and-meta-analysis
#8
REVIEW
Sonia D'Arrigo, Sofia Cacciola, Mark Dennis, Christian Jung, Eisuke Kagawa, Massimo Antonelli, Claudio Sandroni
AIMS: To identify the predictors of survival to discharge in adults resuscitated with extracorporeal cardiopulmonary resuscitation (ECPR) following in-hospital cardiac arrest (IHCA). METHODS: MEDLINE and ISI Web of Science were searched for eligible studies. Pooled Odds Ratio (OR) and Pooled Mean Difference (PMD) for each predictor were calculated. The quality of evidence (QOE) was evaluated according to the GRADE guidelines. RESULTS: Eleven studies were included totalling 856 patients...
October 8, 2017: Resuscitation
https://www.readbyqxmd.com/read/28916353/outcomes-of-adults-with-in-hospital-cardiac-arrest-after-implementation-of-the-2010-resuscitation-guidelines
#9
Chih-Hung Wang, Chien-Hua Huang, Wei-Tien Chang, Min-Shan Tsai, Ping-Hsun Yu, Yen-Wen Wu, Wen-Jone Chen
BACKGROUND: The 2015 guidelines for cardiopulmonary resuscitation (CPR) are based on an update of the 2010 guidelines with minor revisions. It is important to assess the 2010 guidelines to ensure their efficacy, which may help promote widespread adoption of the 2015 guidelines. METHODS: We conducted a retrospective observational study in a single center that evaluated patients with in-hospital cardiac arrest (IHCA) between 2006 and 2014. Multivariable logistic regression analysis was used to evaluate associations between independent variables and outcomes...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28877346/comparable-outcome-of-out-of-hospital-cardiac-arrest-and-in-hospital-cardiac-arrest-treated-with-extracorporeal-life-support
#10
Omar Ellouze, Melitine Vuillet, Justine Perrot, Sandrine Grosjean, Anis Missaoui, Serge Aho, Ghislain Malapert, Belaid Bouhemad, Oliver Bouchot, Claude Girard
Extracorporeal life support (ECLS) has shown benefits in the management of refractory in-hospital cardiac arrest (IHCA) by improving survival. Nonetheless, the results concerning out-of-hospital refractory cardiac arrests (OHCA) remain uncertain. The aim of our investigation was to compare survival between the two groups. We realized a single-center retrospective, observational study of all patients who presented IHCA or OHCA treated with ECLS between 2011 and 2015. Multivariate analysis was realized to determine independent factors associated with mortality...
September 6, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28808363/incidence-characteristics-and-survival-trend-of-cardiopulmonary-resuscitation-following-in-hospital-compared-to-out-of-hospital-cardiac-arrest-in-northern-jordan
#11
Liqaa A Raffee, Shaher M Samrah, Hani Najih Al Yousef, Mahmoud Abu Abeeleh, Khaled Z Alawneh
BACKGROUND: Cardiac arrest remains a leading cause of mortality worldwide. Early cardiopulmonary resuscitation (CPR) is the cornerstone intervention to optimize the survival rates. OBJECTIVES: The main aim of this study was to determine and compare the incidence, characteristics, risk factors, and outcomes of CPR in a referral university hospital following in-hospital cardiac arrests (IHCAs) and out-of-hospital cardiac arrest (OHCA) in Northern Jordan. PATIENTS AND METHODS: Retrospective observational study of adults referred to King Abdulla University Hospital who received CPR between January 2014 and January 2015...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28763260/patterns-of-resuscitation-care-and-survival-after-in-hospital-cardiac-arrest-in-patients-with-advanced-cancer
#12
Jeffrey T Bruckel, Sandra L Wong, Paul S Chan, Steven M Bradley, Brahmajee K Nallamothu
PURPOSE: Little is known regarding patterns of resuscitation care in patients with advanced cancer who suffer in-hospital cardiac arrest (IHCA). METHODS: In the Get With The Guidelines - Resuscitation registry, 47,157 adults with IHCA with and without advanced cancer (defined as the presence of metastatic or hematologic malignancy) were identified at 369 hospitals from April 2006 through June 2010. We compared rates of return of spontaneous circulation (ROSC) and survival to discharge between groups using multivariable models...
October 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28750886/intubation-is-not-a-marker-for-coma-after-in-hospital-cardiac-arrest-a-retrospective-study
#13
Katherine M Berg, Anne V Grossestreuer, Amy Uber, Parth V Patel, Michael W Donnino
INTRODUCTION: In-hospital cardiac arrest (IHCA) strikes over 200,000 people in the United States annually. Targeted temperature management (TTM) is considered beneficial in other settings, but there is no prospective data for IHCA. Recent work on TTM and IHCA found an association between TTM and worse outcome. However, the authors used intubation as a marker for coma to determine eligibility for TTM. The validity of this approach is unexplored. METHODS: Retrospective, single center study of adult patients with IHCA occurring in an intensive care unit, intubated prior to or during the event, or immediately after ROSC...
October 2017: Resuscitation
https://www.readbyqxmd.com/read/28736324/survival-and-neurological-outcome-in-the-elderly-after-in-hospital-cardiac-arrest
#14
G Hirlekar, T Karlsson, S Aune, A Ravn-Fischer, P Albertsson, J Herlitz, B Libungan
BACKGROUND: There have been few studies of the outcome in elderly patients who have suffered in-hospital cardiac arrest (IHCA) and the association between cardiac arrest characteristics and survival. AIM: The aim of this large observational study was to investigate the survival and neurological outcome in the elderly after IHCA, and to identify which factors were associated with survival. METHODS: We investigated elderly IHCA patients (≥70years of age) who were registered in the Swedish Cardiopulmonary Resuscitation Registry 2007-2015...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28734561/avoiding-adult-in-hospital-cardiac-arrest-a-retrospective-cohort-study-to-determine-preventability
#15
Gordon Bingham, Irma Bilgrami, Mandy Sandford, Sarah Larwill, Judit Orosz, Carl Luckhoff, Tony Kambourakis
INTRODUCTION: This study had three main aims. Develop a methodology for reviewing in-hospital cardiac arrests (IHCA). Assess appropriateness and potential preventability of IHCAs. Identify areas for improvement within the rapid response system (RRS). DESIGN: A retrospective cohort study of IHCA identified from an existing organisational electronic database of medical emergency (MET) and Code Blue team activation. Potential preventability of IHCA and Code Blue team activation were established by an expert panel based on a standardised case review process with descriptive and content analyses for each IHCA event...
July 19, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28655621/incidence-and-outcome-of-in-hospital-cardiac-arrest-in-italy-a-multicentre-observational-study-in-the-piedmont-region
#16
Giulio Radeschi, Andrea Mina, Giacomo Berta, Andrea Fassiola, Agostino Roasio, Felice Urso, Roberto Penso, Ugo Zummo, Paola Berchialla, Giuseppe Ristagno, Claudio Sandroni
AIMS: to report the incidence, characteristics, and outcome of in-hospital cardiac arrest (IHCA) in a large Italian region. SETTING: all hospitals participating in the IHCA Registry Initiative of Piedmont. METHODS: observational cohort study in adult (>18year old) inpatients resuscitated from IHCA during three consecutive years (2012-2014). The main outcome measures were IHCA incidence and survival to hospital discharge. RESULTS: A total of1539 arrests in adult inpatients were recorded in the study period, yielding an overall incidence of 1...
October 2017: Resuscitation
https://www.readbyqxmd.com/read/28646562/argininosuccinate-synthase-1-ass1-a-marker-of-unclassified-hepatocellular-adenoma-and-high-bleeding-risk
#17
Elodie Henriet, Aya Abou Hammoud, Jean-William Dupuy, Benjamin Dartigues, Zakaria Ezzoukry, Nathalie Dugot-Senant, Thierry Leste-Lasserre, Nestor Pallares-Lupon, Macha Nikolski, Brigitte Le Bail, Jean-Frédéric Blanc, Charles Balabaud, Paulette Bioulac-Sage, Anne-Aurélie Raymond, Frédéric Saltel
Hepatocellular adenomas (HCA) are rare benign tumors divided into three main subgroups defined by patho-molecular features, HNF1A (H-HCA), mutated β-catenin (b-HCA) and inflammatory (IHCA). In the case of unclassified HCA (UHCA), which are currently identified by default, a high risk of bleeding remains a clinical issue. The objective of this study was to explore UHCA proteome with the aim to identify specific biomarkers. Following dissection of the tumoral (T) and non-tumoral (NT) tissue on formalin-fixed paraffin-embedded (FFPE) from HCA tissue sections using laser capture methodology, we performed mass spectrometry analysis to compare T and NT protein expression levels in HCA, H-HCA, IHCA, b-HCA, UHCA and focal nodular hyperplasia...
June 23, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28637497/influence-of-low-flow-time-on-survival-after-extracorporeal-cardiopulmonary-resuscitation-ecpr
#18
Tobias Wengenmayer, Stephan Rombach, Florian Ramshorn, Paul Biever, Christoph Bode, Daniel Duerschmied, Dawid L Staudacher
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) support under extracorporeal cardiopulmonary resuscitation (eCPR) is the last option and may be offered to selected patients. Several factors predict outcome in these patients, including initial heart rhythm, comorbidities, and bystander cardiopulmonary resuscitation (CPR). We evaluated outcomes of all VA-ECMO patients treated within the last 5 years at our center in respect to low-flow duration during CPR. METHODS: We report retrospective registry data on all patients with eCPR treated at a university hospital between October 2010 and May 2016...
June 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28624147/characteristics-and-outcome-among-14-933-adult-cases-of-in-hospital-cardiac-arrest-a-nationwide-study-with-the-emphasis-on-gender-and-age
#19
Nooraldeen Al-Dury, Araz Rawshani, Johan Israelsson, Anneli Strömsöe, Solveig Aune, Jens Agerström, Thomas Karlsson, Annica Ravn-Fischer, Johan Herlitz
AIM: To investigate characteristics and outcome among patients suffering in-hospital cardiac arrest (IHCA) with the emphasis on gender and age. METHODS: Using the Swedish Register of Cardiopulmonary Resuscitation, we analyzed associations between gender, age and co-morbidities, etiology, management, 30-day survival and cerebral function among survivors in 14,933 cases of IHCA. Age was divided into three ordered categories: young (18-49years), middle-aged (50-64years) and older (65years and above)...
June 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28618047/focal-b-catenin-mutation-identified-on-formalin-fixed-and-paraffin-embedded-inflammatory-hepatocellular-adenomas
#20
Joan Saldarriaga, Bettina Bisig, Gabrielle Couchy, Claire Castain, Jessica Zucman-Rossi, Charles Balabaud, Christine Sempoux, Paulette Bioulac-Sage
The identification of hepatocellular adenoma (HCA) with mutation in exon 3 of the CTNNB1 gene encoding for b-catenin is clinically relevant due to higher risk of malignant transformation. Inflammatory HCA (IHCA) can exhibit b-catenin activation (b-IHCA). We report 2 cases with multiple IHCA in which focal b-catenin activation has been found in one of the IHCA. In both cases, the diagnosis of IHCA was confirmed on the resected nodules by routine stains, immunohistochemical detection of C-reactive protein (CRP), and molecular biology on frozen material...
June 15, 2017: Histopathology
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