Factors influencing the return of spontaneous circulation of patients with out-of-hospital cardiac arrest
01 Jan 2013-Journal of Digital Convergence (The Society of Digital Policy and Management)-Vol. 11, Iss: 9, pp 229-238
TL;DR: It is clear that prehospital CPR, cardiac arrest witness, activity, past history, place, bystander CPR, response time, age, etc are significant contributing factors in ROSC, among 16 cardiac arrest types from decision tree classification, the ROSC rate of type 1 is the highest.
Abstract: 주제어 : 급성 심정지, 병원외 심정지, 자발적 순환 회복, 의사결정나무, 의사결정나무 분류 규칙 Abstract Out-of-hospital cardiac arrest is a major public health problem in Korea. The survival rate to discharge remains at approximately 3.5% and only 1% have good neurological function. To increase the survival rate, prehospital care should restore spontaneous circulation. The purpose of this study was to analyze the factors associated with return of spontaneous circulation(ROSC) after out-of-hospital cardiac arrest. Data used for this study were collected from KCDC Out-of-Hospital Cardiac Arrest Surveillance 2009. As for the results of decision tree analysis, it is clear that prehospital CPR, cardiac arrest witness, activity, past history(cancer/heart disease/stroke), place, bystander CPR, response time, age, etc are significant contributing factors in ROSC. Among 16 cardiac arrest types from decision tree classification, the ROSC rate of type 1 is the highest(29.6%). Also notable is the fact that bystander CPR was strongly correlated with ROSC of patents with cardiac arrest occurring in non-public places. Community resources should be concentrated on increasing bystander CPR and early prehospital emergency care.
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TL;DR: This is the first study to demonstrate the effects of a patient-centered intervention with CPR education tailored for patients' and family caregivers' preferences, needs, and lifestyles and encourage the use of tailored, patient- centered interventions in cardiovascular nursing practice.
Abstract: Purpose: For cardiovascular patients, family caregivers play a vital role in daily nursing and cardiac emergencies. This study aimed to evaluate the effect of patient-centered CPR education (PCE) for family caregivers of patients with cardiovascular diseases. Methods: Fifty-four participants were randomly assigned to the PCE or control group. The PCE group received tailored counseling on overall cardiovascular disease information and CPR followed by interactive instructor-guided CPR training and re-education follow-up by telephone 2 weeks later. The control group received only video-based CPR self-education and booklets. Cardiovascular disease and CPR knowledge and self-efficacy were measured before (pre-test), immediately after (post-test 1), and 4 weeks after the PCE (post-test 2). CPR skills and performance were measured pre-test and at post-test1. Results: The PCE group demonstrated significant improvements in knowledge (F=91.09, p <.001), self-efficacy (F=15.19, p <.001) and CPR skills and performance (F=8.10, p =.008), as well as significant differences over time (knowledge: F=364.25, p <.001; self-efficacy: F=1162.28, p <.001; CPR skills and performance: F=1798.81, p <.001). There were significant group-by-time interactions for knowledge (F=8.10, p =.001), self-efficacy (F=4.30, p =.019) and CPR skills and performance (F=4.81, p =.036) by repeated measures ANOVA. Conclusion: This is the first study to demonstrate the effects of a patient-centered intervention with CPR education tailored for patients’ and family caregivers’ preferences, needs, and lifestyles. The results of this study encourage the use of tailored, patient-centered interventions in cardiovascular nursing practice.
13 citations
TL;DR: Return of spontaneous circulation (ROSC) was lower in areas of long dispatch distance compared to those of short dispatch distance, and it is expected this was most likely due to differences in response time by age and dispatch distance to the scene of cardiac arrest.
Abstract: Purpose: This study measured return of spontaneous circulation (ROSC) in relation to dispatch distance in patients with out-of-hospital cardiac arrest. Methods: Of 2,347 out-of-hospital cardiac arrest patients transported by emergency medical technicians in J Province between January 1 and December 31, 2015, those under age 18, those with reserved resuscitation, and those with traumatic cardiac arrest, leaving 855 patients in the study sample. ROSC was compared between those with dispatch distance ≤4 km (short dispatch distance, 465 patients) and those with dispatch distance >4 km (long dispatch distance, 390 patients). Results: The mean was 2.17 km in the short dispatch group and 9.87 km in the long dispatch group (p=.000). Mean distance from was 6.49 km and 13.39 km in the two groups, respectively (p=.000). ROSC differed significantly between the short and long dispatch distance groups (7.1% for short dispatch distance, 3.6% for long dispatch distance, p=.025). The length of time from to cardiopulmonary resuscitation also differed significantly between the short and long dispatch distance groups (8.77 minutes and 14.63 minutes, respectively, p=.000). Conclusion: ROSC was lower in areas of long dispatch distance compared to those of short dispatch distance. We expect this was most likely due to differences in response time by age and dispatch distance to the scene of cardiac arrest. However, no significant differences were found between the groups in the factors affecting ROSC.
1 citations
Additional excerpts
...이러한 반응시간의 지연은 병원 전 심정지 환자의 생존율이 감소하는 요인으로 Koh 등[3]은 심정지 발생 후 신고부터 병원 도착까지의 시간을 최소화한다면 병원 전 심정지 환자의 예후 향상을 기대할 수 있을 것으로 보고하였으며, Park 등[4]도 심정지 발생 후 빠른 시간 내에 심 폐소생술이 시행될 경우 자발순환회복 여부에 영 향을 주게 되어 구급차가 현장에 도착하는 시간을 단축시킬 것을 주장하였다....
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10 May 2019
TL;DR: According to inadequate knowledge and negative attitude of most participants, the community-based education courses with a simple language is recommended to increase the awareness and develop a positive attitude toward CPR in families of patients with coronary artery disease.
Abstract: Background & objectives: Cardio-Pulmonary arrest may occur at any time and any place. Nearly 70% of cases with cardiac arrest occur at home or outside the hospital without access to experienced people for cardiopulmonary resuscitation (CPR). So if people and family members of patients with heart problems (bystanders) have the ability to perform primary CPR, they can save lifes in the golden hour. This study was conducted to evaluate the knowledge and attitude of family carers of patients with coronary artery disease about CPR. Methods: This crosssectional study was conducted on 110 family carers of patients with coronary artery disease at cardiac care units of Tabriz hospitals. The samples were selected by convenience sampling method and data were collected through a researcher-made questionnaire of knowledge and attitude. Data were analyzed by SPSS software version 21. Results: The knowledge of most participants was undesirable (56.3%). The highest and lowest levels of knowledge were related to "facing with disease" and "time of chest cardic massage", respectively. In terms of attitude, most participants (52.1%) had a negative attitude toward resuscitation, and most (79.1%) believed that the patient should survive as much as possible. Conclusion: According to inadequate knowledge and negative attitude of most participants, the community-based education courses with a simple language is recommendedto increase the awareness and develop a positive attitude toward CPR in families of patients with coronary artery disease .
References
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Book•
10 Jun 1997
TL;DR: One of the first practical guides to mining business data, Data Mining Techniques describes techniques for detecting customer behavior patterns useful in formulating marketing, sales, and customer support strategies.
Abstract: From the Publisher:
Data Mining Techniques thoroughly acquaints you with the new generation of data mining tools and techniques and shows you how to use them to make better business decisions. One of the first practical guides to mining business data, it describes techniques for detecting customer behavior patterns useful in formulating marketing, sales, and customer support strategies. While database analysts will find more than enough technical information to satisfy their curiosity, technically savvy business and marketing managers will find the coverage eminently accessible. Here's your chance to learn all about how leading companies across North America are using data mining to beat the competition; how each tool works, and how to pick the right one for the job; seven powerful techniques - cluster detection, memory-based reasoning, market basket analysis, genetic algorithms, link analysis, decision trees, and neural nets, and how to prepare data sources for data mining, and how to evaluate and use the results you get. Data Mining Techniques shows you how to quickly and easily tap the gold mine of business solutions lying dormant in your information systems.
1,823 citations
TL;DR: Sudden cardiac arrest usually occurs at home, and the survival of those with a witnessed SCA at home was low compared with that outside the home, indicating the necessity of optimizing out-of-hospital resuscitation, especially in the at-home situation.
825 citations
Additional excerpts
...전체적으로 연령이 낮은 집단에서 자발 적 순환 회복률이 높게 나타났으며 이는 기존 연구의 결 과와 일치하였다[13, 14, 15]....
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TL;DR: A representative European incidence and survival from cardiac arrest in all-rhythms and in ventricular fibrillation treated by the emergency medical services (EMS) is determined and provides a framework to assess opportunities and limitations of EMS care with regard to the public health burden of cardiac Arrest in Europe.
822 citations
TL;DR: A representative national incidence of emergency medical services (EMS)-treated all-rhythm and ventricular fibrillation (VF) SCA as well as survival is determined to assess opportunities and limitations of EMS care with regard to the public health burden of SCA.
493 citations
Additional excerpts
...즉, 병원 도착전까지 CPR 시행 여부 가 심정지 환자의 생존에 매우 중요한 요소임이 파악되 었으며, 이는 선행연구조사의 결과와도 일치하였다 [10,11,12]....
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TL;DR: An inexpensive, multifaceted system optimization approach to rapid defibrillation can lead to significant improvements in survival after cardiac arrest in a large BLS-D EMS system.
Abstract: ContextSurvival rates for out-of-hospital cardiac arrest are
low; published survival rates in Ontario are only 2.5%. This study
represents phase II of the Ontario Prehospital Advanced Life Support
(OPALS) study, which is designed to systematically evaluate the
effectiveness and efficiency of various prehospital interventions for
patients with cardiac arrest, trauma, and critical illnesses.ObjectiveTo assess the impact on out-of-hospital
cardiac arrest survival of the implementation of a rapid defibrillation
program in a large multicenter emergency medical services (EMS) system
with existing basic life support and defibrillation (BLS-D) level of
care.DesignControlled clinical trial comparing survival for 36 months
before (phase I) and 12 months after (phase II) system optimization.SettingNineteen urban and suburban Ontario communities
(populations ranging from 16,000 to 750,000 [total, 2.7
million]).PatientsAll patients who had out-of-hospital cardiac arrest in
the study communities for whom resuscitation was attempted by emergency
responders.InterventionsStudy communities optimized their EMS systems to
achieve the target response interval from when a call was received
until a vehicle stopped with a defibrillator of 8 minutes or less for
90% of cardiac arrest cases. Working both locally and provincially,
communities implemented multiple measures, including defibrillation by
firefighters, base paging, tiered response agreements with fire
departments, continuous quality improvement for response intervals, and
province-wide revision and implementation of standard dispatch
policies. All response times were obtained from a central dispatch
system.Main Outcome MeasureSurvival to hospital discharge.ResultsThe 4690 cardiac arrest patients studied in phase I and
the 1641 in phase II were similar for all clinical and demographic
characteristics, including age, sex, witnessed status, rhythm, and
receipt of bystander cardiopulmonary resuscitation. The proportion of
cases meeting the 8-minute response criterion improved (76.7% vs
92.5%; P<.001) as did most median response intervals.
Overall survival to hospital discharge for all rhythm groups combined
improved from 3.9% to 5.2% (P=.03). The 33%
relative increase in survival represents an additional 21 lives saved
each year in the study communities (approximately 1 life per
120,000 residents). The charges were estimated to be US
$46,900 per life saved for establishing the rapid defibrillation
program and US $2400 per life saved annually for maintaining the
program.ConclusionAn inexpensive, multifaceted system optimization
approach to rapid defibrillation can lead to significant improvements
in survival after cardiac arrest in a large BLS-D EMS
system.
357 citations
Additional excerpts
...즉, 병원 도착전까지 CPR 시행 여부 가 심정지 환자의 생존에 매우 중요한 요소임이 파악되 었으며, 이는 선행연구조사의 결과와도 일치하였다 [10,11,12]....
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