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Angiographic findings and survival in patients undergoing coronary angiography due to sudden cardiac arrest in western Sweden.

https://arctichealth.org/en/permalink/ahliterature269292
Source
Resuscitation. 2015 May;90:13-20
Publication Type
Article
Date
May-2015
Author
Björn Redfors
Truls Råmunddal
Oskar Angerås
Christian Dworeck
Inger Haraldsson
Dan Ioanes
P. Petursson
Berglind Libungan
Jacob Odenstedt
Jason Stewart
Lotta Robertsson
Magnus Wahlin
Per Albertsson
Johan Herlitz
Elmir Omerovic
Source
Resuscitation. 2015 May;90:13-20
Date
May-2015
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - mortality - radiography - therapy
Aged
Coronary Angiography
Coronary Artery Disease - mortality - radiography - therapy
Coronary Occlusion - mortality - radiography - therapy
Female
Heart Arrest - mortality
Humans
Logistic Models
Male
Percutaneous Coronary Intervention
Propensity Score
Proportional Hazards Models
Prospective Studies
Registries
Severity of Illness Index
Sweden - epidemiology
Abstract
Sudden cardiac arrest (SCA) accounts for more than half of all deaths from coronary heart disease. Time to return of spontaneous circulation is the most important determinant of outcome but successful resuscitation also requires percutaneous coronary intervention in selected patients. However, proper selection of patients is difficult. We describe data on angiographic finding and survival from a prospectively followed SCA patient cohort.
We merged the RIKS-HIA registry (Register of Information and Knowledge about Swedish Heart Intensive Care Admissions) and SCAAR (Swedish Coronary Angiography and Angioplasty Registry) for patients hospitalized in cardiac care units in Western Sweden between January 2005 and March 2013. We performed propensity score-adjusted logistic and Cox proportional-hazards regression analyses on complete-case data as well as on imputed data sets.
638 consecutive patients underwent coronary angiography due to SCA. Severity of coronary artery disease was similar among SCA patients and patients undergoing coronary angiography due to suspected coronary artery disease (n=37,142). An acute occlusion was reported in the majority of SCA patients and was present in 37% of patients who did not have ST-elevation on the post resuscitation ECG. 31% of SCA patients died within 30 days. Long-term risk of death among patients who survived the first 30 days was higher in patients with SCA compared to patients with acute coronary syndromes (P
PubMed ID
25698668 View in PubMed
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The attitude of cardiac care patients towards CPR and CPR education.

https://arctichealth.org/en/permalink/ahliterature53348
Source
Resuscitation. 2004 May;61(2):163-71
Publication Type
Article
Date
May-2004
Author
Ann-Britt Thorén
Asa Axelsson
Johan Herlitz
Author Affiliation
Division of Cardiology, Sahlgrenska University Hospital, Röda Stråket 4, SE-413, Göteborg 45, Sweden. ann-britt.thoren@vgregion.se
Source
Resuscitation. 2004 May;61(2):163-71
Date
May-2004
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Analysis of Variance
Attitude to Health
Cardiopulmonary Resuscitation - education - psychology - statistics & numerical data
Cohort Studies
Comparative Study
Coronary Care Units
Coronary Disease - psychology - therapy
Emergency medical services
Family - psychology
Female
Humans
Male
Middle Aged
Patient Education - statistics & numerical data
Patient Participation - psychology - statistics & numerical data
Probability
Questionnaires
Research Support, Non-U.S. Gov't
Risk assessment
Sex Factors
Sweden
Abstract
The recommended targeting of the elderly, those with heart conditions and their family members for CPR education remains unaccomplished. Little is known about cardiac patients' knowledge of and attitude towards CPR and CPR education. This study aimed to investigate cardiac care patients' attitude towards CPR and interest in CPR education. An interview, based on a questionnaire, was conducted with 401 consecutive patients admitted to a coronary care unit. Most participants had heard about the concept of CPR and 64% were aware of its content. In the event of an emergency, 96% were willing to undergo CPR. Age, previous myocardial infarction and heart failure were significantly associated with the willingness or lack of willingness to undergo CPR. Forty percent of the participants had attended one or more courses but only a few within the last two years. The major reasons for not being educated in CPR were a lack of awareness of the availability of CPR training for the public, lack of interest or lack of enterprise. Among those not educated in CPR, 46% would like to attend a course. A hospital was the preferred location for the course, often due to the perceived higher competence of the instructors, but sometimes, because it offered a safe environment. The primary health care centre was preferred because of its location near the participants' homes. In order to increase the proportion of people trained in CPR in target groups such as cardiac care patients and their family members, healthcare professionals should provide patients with information and opportunities to attend locally situated, professionally led courses.
PubMed ID
15135193 View in PubMed
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Cardiac arrest after pulmonary aspiration in hospitalised patients: a national observational study.

https://arctichealth.org/en/permalink/ahliterature306512
Source
BMJ Open. 2020 03 19; 10(3):e032264
Publication Type
Journal Article
Observational Study
Date
03-19-2020
Author
Malin Albert
Johan Herlitz
Araz Rawshani
Mattias Ringh
Andreas Claesson
Therese Djärv
Per Nordberg
Author Affiliation
Department of Clinical Science and Education, Sodersjukhuset, Karolinska Institutet, Stockholm, Sweden malin.albert@sll.se.
Source
BMJ Open. 2020 03 19; 10(3):e032264
Date
03-19-2020
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation
Critical Care
Female
Heart Arrest - etiology - mortality - therapy
Hospitalization
Humans
Male
Middle Aged
Respiratory Aspiration - complications - mortality
Retrospective Studies
Sweden
Abstract
To study characteristics and outcomes among patients with in-hospital cardiac arrest (IHCA) due to pulmonary aspiration.
A retrospective observational study based on data from the Swedish Registry of Cardiopulmonary Resuscitation (SRCR).
The SRCR is a nationwide quality registry that covers 96% of all Swedish hospitals. Participating hospitals vary in size from secondary hospitals to university hospitals.
The study included patients registered in the SRCR in the period 2008 to 2017. We compared patients with IHCA caused by pulmonary aspiration (n=127), to those with IHCA caused by respiratory failure of other causes (n=2197).
Primary outcome was 30-day survival. Secondary outcome was sustained return of spontaneous circulation (ROSC) defined as ROSC at the scene and admitted alive to the intensive care unit.
In the aspiration group 80% of IHCA occurred on general wards, as compared with 63.6% in the respiratory failure group (p
PubMed ID
32198299 View in PubMed
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Cardiac arrest due to drowning--changes over time and factors of importance for survival.

https://arctichealth.org/en/permalink/ahliterature258983
Source
Resuscitation. 2014 May;85(5):644-8
Publication Type
Article
Date
May-2014
Author
Andreas Claesson
Jonny Lindqvist
Johan Herlitz
Source
Resuscitation. 2014 May;85(5):644-8
Date
May-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Near Drowning
Out-of-Hospital Cardiac Arrest - mortality - therapy
Retrospective Studies
Survival Rate
Sweden - epidemiology
Treatment Outcome
Abstract
To evaluate changes in characteristics and survival over time in out-of-hospital cardiac arrest (OHCA) due to drowning and describe factors of importance for survival.
Retrospectively reported and treated drowning cases reported to the Swedish OHCA registry between 1990 and 2012, n=529. The data were clustered into three seven-year intervals for comparisons of changes over time.
There were no changes in age, gender, witnessed status, shockable rhythm or place of OHCA during the time periods. Bystander CPR increased over time, 59% in interval 1992-1998, versus 74% in interval 2006-2012 (p=0.005). There was a decrease in delay between OHCA and calling for the Emergency Medical Service (EMS) over the years, while calling for the EMS to arrival increased in terms of time. Survival to hospital admission appears to have increased over the years (p=0.009), whereas survival to one month did not change significantly over time. In a multivariate analysis, witnessed status, female gender, bystander CPR, place-home and EMS response time were associated with survival to hospital admission. For survival to one month, place, age, shockable rhythm and logarithmised delay from calling for an ambulance to arrival were of significance for survival.
In OHCA due to drowning, over a period of 20 years, bystanders have called for help at an earlier stage and administered CPR more frequently in the past few years. Survival to hospital admission has increased, while shockable rhythm and early arrival of the EMS appear to be the most important factors for survival to one month.
PubMed ID
24560828 View in PubMed
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Cardiac arrest in COVID-19: characteristics and outcomes of in- and out-of-hospital cardiac arrest. A report from the Swedish Registry for Cardiopulmonary Resuscitation.

https://arctichealth.org/en/permalink/ahliterature311369
Source
Eur Heart J. 2021 03 14; 42(11):1094-1106
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Date
03-14-2021
Author
Pedram Sultanian
Peter Lundgren
Anneli Strömsöe
Solveig Aune
Göran Bergström
Eva Hagberg
Jacob Hollenberg
Jonny Lindqvist
Therese Djärv
Albert Castelheim
Anna Thorén
Fredrik Hessulf
Leif Svensson
Andreas Claesson
Hans Friberg
Per Nordberg
Elmir Omerovic
Annika Rosengren
Johan Herlitz
Araz Rawshani
Author Affiliation
University of Gothenburg, Institute of Medicine, Department of Molecular and Clinical Medicine, Gothenburg, Sweden.
Source
Eur Heart J. 2021 03 14; 42(11):1094-1106
Date
03-14-2021
Language
English
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
COVID-19 - complications - mortality
Cardiopulmonary Resuscitation
Female
Heart Arrest - etiology - mortality
Humans
Male
Middle Aged
Out-of-Hospital Cardiac Arrest - etiology
Registries
Survival Rate
Sweden
Abstract
To study the characteristics and outcome among cardiac arrest cases with COVID-19 and differences between the pre-pandemic and the pandemic period in out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA).
We included all patients reported to the Swedish Registry for Cardiopulmonary Resuscitation from 1 January to 20 July 2020. We defined 16 March 2020 as the start of the pandemic. We assessed overall and 30-day mortality using Cox regression and logistic regression, respectively. We studied 1946 cases of OHCA and 1080 cases of IHCA during the entire period. During the pandemic, 88 (10.0%) of OHCAs and 72 (16.1%) of IHCAs had ongoing COVID-19. With regards to OHCA during the pandemic, the odds ratio for 30-day mortality in COVID-19-positive cases, compared with COVID-19-negative cases, was 3.40 [95% confidence interval (CI) 1.31-11.64]; the corresponding hazard ratio was 1.45 (95% CI 1.13-1.85). Adjusted 30-day survival was 4.7% for patients with COVID-19, 9.8% for patients without COVID-19, and 7.6% in the pre-pandemic period. With regards to IHCA during the pandemic, the odds ratio for COVID-19-positive cases, compared with COVID-19-negative cases, was 2.27 (95% CI 1.27-4.24); the corresponding hazard ratio was 1.48 (95% CI 1.09-2.01). Adjusted 30-day survival was 23.1% in COVID-19-positive cases, 39.5% in patients without COVID-19, and 36.4% in the pre-pandemic period.
During the pandemic phase, COVID-19 was involved in at least 10% of all OHCAs and 16% of IHCAs, and, among COVID-19 cases, 30-day mortality was increased 3.4-fold in OHCA and 2.3-fold in IHCA.
Notes
CommentIn: Eur Heart J. 2021 Mar 14;42(11):1107-1109 PMID 33543260
CommentIn: Eur Heart J. 2021 Apr 14;42(15):1528-1529 PMID 33755104
PubMed ID
33543259 View in PubMed
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Cardiac arrest outside and inside hospital in a community: mechanisms behind the differences in outcome and outcome in relation to time of arrest.

https://arctichealth.org/en/permalink/ahliterature97138
Source
Am Heart J. 2010 May;159(5):749-56
Publication Type
Article
Date
May-2010
Author
Martin Fredriksson
Solveig Aune
Angela Bång
Ann-Britt Thorén
Jonny Lindqvist
Thomas Karlsson
Johan Herlitz
Author Affiliation
Institution of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
Source
Am Heart J. 2010 May;159(5):749-56
Date
May-2010
Language
English
Publication Type
Article
Keywords
Aged
Cardiopulmonary Resuscitation
Emergency medical services
Female
Heart Arrest - mortality - therapy
Humans
Male
Multivariate Analysis
Survival Analysis
Sweden
Treatment Outcome
Abstract
BACKGROUND: The aim was to compare characteristics and outcome after cardiac arrest where cardiopulmonary resuscitation was attempted outside and inside hospital over 12 years. METHODS: All out-of-hospital cardiac arrests (OHCAs) in Göteborg between 1994 and 2006 and all in-hospital cardiac arrests (IHCAs) in 1 of the city's 2 hospitals for whom the rescue team was called between 1994 and 2006 were included in the survey. RESULTS: The study included 2,984 cases of OHCA and 1,478 cases of IHCA. Patients with OHCA differed from those with an IHCA; they were younger, included fewer women, were less frequently found in ventricular fibrillation, and were treated later. If patients were found in a shockable rhythm, survival to 1 month/discharge was 18% after OHCA and 61% after IHCA (P
PubMed ID
20435182 View in PubMed
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Cardiac disease and probable intent after drowning.

https://arctichealth.org/en/permalink/ahliterature113660
Source
Am J Emerg Med. 2013 Jul;31(7):1073-7
Publication Type
Article
Date
Jul-2013
Author
Andreas Claesson
Henrik Druid
Jonny Lindqvist
Johan Herlitz
Author Affiliation
Kungälv Ambulance Service, SE-442 40 Kungälv, Sweden. andreas.claesson@telia.com
Source
Am J Emerg Med. 2013 Jul;31(7):1073-7
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Drowning - etiology - mortality
Female
Heart Diseases - complications - epidemiology
Homicide - statistics & numerical data
Humans
Male
Middle Aged
Out-of-Hospital Cardiac Arrest - etiology - mortality
Prevalence
Registries
Retrospective Studies
Suicide - statistics & numerical data
Sweden - epidemiology
Abstract
The aim of this study is to determine the prevalence of cardiac disease and its relationship to the victim's probable intent among patients with cardiac arrest due to drowning.
Retrospective autopsied drowning cases reported to the Swedish National Board of Forensic Medicine between 1990 and 2010 were included, alongside reported and treated out-of-hospital cardiac arrests due to drowning from the Swedish Out of Hospital Cardiac Arrest Registry that matched events in the National Board of Forensic Medicine registry (n = 272).
Of 2166 drowned victims, most (72%) were males; the median age was 58 years (interquartile range, 42-71 years). Drowning was determined to be accidental in 55%, suicidal in 28%, and murder in 0.5%, whereas the intent was unclear in 16%. A contributory cause of death was found in 21%, and cardiac disease as a possible contributor was found in 9% of all autopsy cases. Coronary artery sclerosis (5%) and myocardial infarction (2%) were most frequent. Overall, cardiac disease was found in 14% of all accidental drownings, as compared with no cases (0%) in the suicide group; P = .05. Ventricular fibrillation was found to be similar in both cardiac and noncardiac cases (7%). This arrhythmia was found in 6% of accidents and 11% of suicides (P = .23).
Among 2166 autopsied cases of drowning, more than half were considered to be accidental, and less than one-third, suicidal. Among accidents, 14% were found to have a cardiac disease as a possible contributory factor; among suicides, the proportion was 0%. The low proportion of cases showing ventricular fibrillation was similar, regardless of the presence of a cardiac disease.
PubMed ID
23702057 View in PubMed
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Cause of death during 13 years after coronary artery bypass grafting with emphasis on cardiac death.

https://arctichealth.org/en/permalink/ahliterature17413
Source
Scand Cardiovasc J. 2004 Oct;38(5):283-6
Publication Type
Article
Date
Oct-2004
Author
Johan Herlitz
Gunnar Brandrup-Wognsen
Kenneth Caidahl
Maria Haglid-Evander
Marianne Hartford
Björn Karlson
Thomas Karlsson
Helén Sjöland
Author Affiliation
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden. johan.herlitz@hjl.gu.se
Source
Scand Cardiovasc J. 2004 Oct;38(5):283-6
Date
Oct-2004
Language
English
Publication Type
Article
Keywords
Aged
Cause of Death
Coronary Arteriosclerosis - mortality
Coronary Artery Bypass - mortality
Female
Humans
Male
Middle Aged
Prospective Studies
Research Support, Non-U.S. Gov't
Risk factors
Sweden - epidemiology
Time Factors
Abstract
OBJECTIVE: To describe the cause of death in the long term after coronary artery bypass grafting (CABG) with particular emphasis on cardiac death. PATIENTS AND SETTING: All the patients in western Sweden without simultaneous valve surgery and without previous CABG who underwent CABG in 1988-1991 in Göteborg, Sweden. DESIGN: Prospective, observational study for 10.6-13.6 years (i.e. until the end of 2001). Various factors contributing to death were described, with the emphasis on cardiac death. RESULTS: In all, 2000 patients were included in the survey. The all-cause mortality rate was 39%. Fifty-eight per cent of all deaths were judged as cardiac deaths. The most frequent cause of death was heart failure (65% among patients who died within 30 days after CABG and 36% among those who died >30 days after CABG). The second most common cause of death was myocardial infarction (56 and 29%, respectively), followed by cancer (0 and 24%, respectively), stroke (21 and 18%, respectively) and infection (8 and 11%, respectively). CONCLUSION: The factors most commonly contributing to death in the long term after CABG were, in order of frequency, heart failure, myocardial infarction, cancer, stroke and infection.
PubMed ID
15513311 View in PubMed
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Changes in demographic factors and mortality after out-of-hospital cardiac arrest in Sweden.

https://arctichealth.org/en/permalink/ahliterature53223
Source
Coron Artery Dis. 2005 Feb;16(1):51-7
Publication Type
Article
Date
Feb-2005
Author
Johan Herlitz
Johan Engdahl
Leif Svensson
Marie Young
Karl-Axel Angquist
Stig Holmberg
Author Affiliation
Division of Cardiology, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden. johan.herlitz@hjl.gu.se
Source
Coron Artery Dis. 2005 Feb;16(1):51-7
Date
Feb-2005
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation - methods - mortality
Cause of Death
Comparative Study
Emergency Medical Services - statistics & numerical data
Female
Heart Arrest - mortality - therapy
Humans
Male
Middle Aged
Probability
Prospective Studies
Registries
Research Support, Non-U.S. Gov't
Sex Distribution
Survival Analysis
Sweden - epidemiology
Abstract
OBJECTIVE: To describe changes between 1992 and 2003 in age, sex, factors at resuscitation and survival among patients suffering from out-of-hospital cardiac arrest in Sweden. METHODS: This was a prospective observational study including various ambulance organizations in Sweden. Patients suffering from out-of-hospital cardiac arrest between 1992 and 2003 included in the Swedish Cardiac Arrest Registry were followed for survival to 1 month. RESULTS: In all 19 791 cases took part in the survey. There was a slight increase in mean age from 68 to 70 years (P = 0.025) and an increase of females from 29 to 32% (P = 0.0001). There was a change in witnessed status (P
PubMed ID
15654201 View in PubMed
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Characteristics and outcome among 14,933 adult cases of in-hospital cardiac arrest: A nationwide study with the emphasis on gender and age.

https://arctichealth.org/en/permalink/ahliterature288036
Source
Am J Emerg Med. 2017 Dec;35(12):1839-1844
Publication Type
Article
Date
Dec-2017
Author
Nooraldeen Al-Dury
Araz Rawshani
Johan Israelsson
Anneli Strömsöe
Solveig Aune
Jens Agerström
Thomas Karlsson
Annica Ravn-Fischer
Johan Herlitz
Source
Am J Emerg Med. 2017 Dec;35(12):1839-1844
Date
Dec-2017
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Cardiopulmonary Resuscitation - mortality - statistics & numerical data
Comorbidity
Female
Heart Arrest - mortality - therapy
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Prognosis
Sex Factors
Survival Analysis
Survival Rate
Sweden - epidemiology
Time Factors
Treatment Outcome
Abstract
To investigate characteristics and outcome among patients suffering in-hospital cardiac arrest (IHCA) with the emphasis on gender and age.
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). Comparisons between men and women were age adjusted.
The mean age was 72.7years and women were significantly older than men. Renal dysfunction was the most prevalent co-morbidity. Myocardial infarction/ischemia was the most common condition preceding IHCA, with men having 27% higher odds of having MI as the underlying etiology. A shockable rhythm was found in 31.8% of patients, with men having 52% higher odds of being found in VT/VF. After adjusting for various confounders, it was found that men had a 10% lower chance than women of surviving to 30days. Older individuals were managed less aggressively than younger patients. Increasing age was associated with lower 30-day survival but not with poorer cerebral function among survivors.
When adjusting for various confounders, it was found that men had a 10% lower chance than women of surviving to 30days after in-hospital cardiac arrest. Older individuals were managed less aggressively than younger patients, despite a lower chance of survival. Higher age was, however, not associated with poorer cerebral function among survivors.
PubMed ID
28624147 View in PubMed
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117 records – page 1 of 12.