Circumstances of out of hospital cardiac arrest in patients with ischaemic heart disease

Abstract

Objectives: To discover the circumstances of out of hospital cardiac death irrespective of resuscitation attempts. Design: Prospective community study over the two years 1994 and 1995. Setting: The health districts of Brighton, South Glamorgan, and York, UK. Subjects: 1290 victims of sudden death or cardiac arrest caused by coronary heart disease who were under 76 years of age. Interventions: Basic and advanced life support for witnessed cardiac arrests. Main outcome measures: Survival to reach hospital and for 30 days after the arrest. Results: 35 (35%) of 101 patients (mean age 64) whose arrest was witnessed by a doctor or paramedic survived for 30 days compared with 9 of 464 (2%) whose arrest was witnessed by a relative or bystander at home (mean age 66) and 15 of 200 (8%) whose arrest was witnessed in a public place (mean age 61). None of the 525 victims of an unwitnessed arrest survived but the majority of those whose arrest was witnessed had complained of new symptoms before the arrest. Victims who were given basic life support by relatives or bystanders had better survival (14 of 183 (8%)) than those who were not (10 of 481 (2%), p , 0.001). Of the 20% of arrests that occurred in public places, few were in places where public access defibrillators would now be available. Conclusions: The burden of out of hospital cardiac arrest is mainly in the home but most victims have premonitory symptoms. Public education to seek help urgently for new or prolonged chest pain seems the most promising method to address the problem.

Sudden cardiac arrest in the region of Lausanne: a 5 years consecutive observational study

“…Our data are roughly in accordance with other previously reported studies in Europe [9][10][11][12][13]. The calculated mean annual incidence of outof-hospital SCA in our study is 0.4 per 1000 inhabitants; it is in the lower range of values of other published studies reporting an incidence varying between 0.36 and 1.3‰ [11,12].…”

Trends in Out-of-Hospital Deaths Due to Coronary Heart Disease in Sweden (1991 to 2006)

“…In the present study, details of death were not available, other than that it occurred without hospital admission. In a recent study from the United Kingdom of 1290 out-of-hospital CHD deaths or cases of cardiac arrest, fewer than half were witnessed, 27 which indicates that a 1-hour definition, even if the data were available, would decrease the proportion with sudden cardiac death considerably.…”

Circumstances and Outcomes of Sudden Unexpected Death in Patients With High-Risk Myocardial Infarction

“…[12][13][14][15][16] To better understand the circumstances and outcomes of sudden death events over time in high-risk patients after MI, we studied patients with sudden unexpected death or cardiac arrest with resuscitation in the Valsartan in Acute Myocardial Infarction Trial (VALIANT).…”

“…Kulcsszavak: cardialis aritmia I hirtelen halál I implantálható defibrillátor I myocardialis infarctus I kamrai tachycardia Bár az átlagpopulációban a kórházon kívül bekövetkező szívmegállás körülményei jól ismertek, a korábban MI-n át-esett betegeknél a hirtelen halál ezen aspektusának jellemzői-ről az ismeretek korlátozottak. [12][13][14][15][16] A nagy kockázatú, MI-n átesett betegekben az eltelt idő függvényében fellépő hirtelen halál körülményeinek és kimenetelének jobb megértése érde-kében olyan betegeket vizsgáltunk, akiknél a VALIANT (Valsartan in Acute Myocardial Infarction -Valsartan akut myocardialis infarctusban) tanulmányban hirtelen halál vagy szív-megállás miatt újraélesztés történt.…”