OBJECTIVE: Reporting epidemiological data on prehospital cardiac arrest in the Pilsen Region in 2022. Expression of cardiopulmonary resuscitation success using the Cerebral Performance Category (CPC) score. MATERIALS AND METHODS: The study looked at the survival rate of out-of-hospital sudden cardiac arrest in all patients in whom emergency medical services performed cardiopulmonary resuscitation (CPR). The study covered the period from 1 January 2022 to 31 December 2022. Both electronic and paper medical records were used to obtain data. All cases were evaluated according to Utstein-style guidelines. RESULTS: During the studied period, emergency response teams in the Pilsen Region carried out CPR in 499 cases. The incidence of prehospital CPR was 88.43 cases per 100,000 population. A total of 146 patients (29.26%) were referred to the hospital with spontaneous circulation, and results indicating survival with a good neurological outcome of CPC 1 or 2 were recorded in 48 cases (9.62%). The first monitored rhythm was shockable in 119 cases (23.85%). In this subgroup, ROSC was achieved in 71 cases (59.66%) and 61 of them (51.26%) were referred to hospital. In this study subgroup, a total of 36 patients (30.25%) achieved a good neurological outcome with a CPC score of 1 or 2. CONCLUSION: The study presented epidemiological data on OHCA and prehospital CPR in the Pilsen region in 2022. The data obtained shows a survival rate with good neurological outcome in 9.62% of cases.
INTRODUCTION: Cardiopulmonary resuscitation (CPR)-related injuries have not been assessed since the 2015 Resuscitation Guidelines were established. AIM: To describe the incidence and severity of CPR-related injuries, and to evaluate the impact of the 2015 European Resuscitation Council (ERC) guidelines on the objective assessment of injuries. METHODS: This multicenter, retrospective study analyzed autopsy reports of patients who underwent CPR. The most severe injuries were objectively assessed using the Abbreviated Injury Scale (AIS) and all injuries were summarized according to the New Injury Severity Score (NISS). RESULTS: Among 628 autopsy reports analyzed, patient characteristics and case details were distributed as follows: male sex, 71.1%; median age, 67 years; out-of-hospital cardiac arrest, 89.2%; bystander CPR, 56.8%. CPR-related injuries included: rib(s) 94.6%; lung(s), 9.9%; sternum, 62.4%; liver, 2.5%; and spleen, 1.8%. The incidence of bystander-provided CPR and severity of injury were similar to CPR provided only by professionals. There were no difference between mechanical and manual compressions. Females were older (p = 0.0001) and, although the frequency of their injuries was similar to males, they were significantly more severe (p = 0.01). Patients with life-threatening injury exhibited a baseline profile similar to those without injury . The median score (according to AIS) of the most severe injury was 3 and the median of summary of injuries was 13 according to the NISS-low risk of fatal injury. CONCLUSION: CPR-related injuries occurred frequently, although those that were life-threatening accounted for only 3% of cases. There were no differences between patients who were resuscitated by bystander(s) or by professionals and no differences between mechanical chest devices or manual resuscitation. Compared with a study based on the 2010 guidelines, similar injuries were found, but with more rib fractures, less visceral organ damage, and fewer life-threatening injuries.
- MeSH
- fraktury žeber * epidemiologie etiologie MeSH
- kardiopulmonální resuscitace * škodlivé účinky MeSH
- lidé MeSH
- pitva MeSH
- retrospektivní studie MeSH
- senioři MeSH
- zástava srdce mimo nemocnici * epidemiologie terapie komplikace MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
AIMS: To acquire epidemiological data on pre-hospital cardiac arrest incidents occurring in the Pilsen Region of the Czech Republic in 2018, and the results of subsequent cardiopulmonary resuscitation Methods. A prospective observational study of the survival rate of out-of-hospital cardiac arrest (OHCA) in patients undergoing CPR carried out by emergency medical service personnel. The observed time period was from January 1st, 2018 until December 31st, 2018. The data were acquired from patients' records in paper and electronic forms. RESULTS: In the monitored period 707 patients with signs of cardiac arrest were recorded in the Pilsen Region with an incidence rate of 128.9 per 100,000 inhabitants. Emergency medical units performed CPR in 484 cases. The incidence rate of pre-hospital CPR was 88.2 cases per 100,000 inhabitants. Spontaneous blood circulation was temporarily or permanently restored in 276 patients (57.0%), 203 (41.9%) patients were transferred to a hospital, and there were 61 (12.6%) cases of survival with Cerebral Performance Category (CPC) score of 1 or 2. The first monitored rhythm was a shockable in 134 (27.7%) cases. In this sub-group ROSC was achieved in 94 (70.1%) cases and 58 (43.3%) of those were subsequently transferred to a hospital. A good CPC result was achieved in 41 (30.6%) patients of this sub group. CONCLUSION: The study has provided valuable epidemiological data on OHCA and prehospital CPR in the area of the Pilsen Region in 2018. The collected data, compared to international results, show a higher survival rate with good neurological score in 12.6% of cases.
- MeSH
- dítě MeSH
- dospělí MeSH
- kardiopulmonální resuscitace * MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- mladiství MeSH
- mladý dospělý MeSH
- předškolní dítě MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- zástava srdce mimo nemocnici epidemiologie terapie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Geografické názvy
- Česká republika MeSH
Článek přináší informace o vybraných aspektech mimonemocniční zástavy oběhu v kontextu pandemie onemocnění COVID-19. Dopad pandemie na vybrané demografické a zdravotní charakteristiky je zřetelný především v oblasti zvýšení počtu pacientů s mimonemocniční zástavou oběhu s dominujícím místem postižení v domácím prostředí. V době pandemie byl zaznamenán nižší počet pacientů se vstupním defibrilovatelným rytmem a návratem spontánního oběhu. Dále je v článku uveden modifikovaný postup základní resuscitace s použitím automatizovaného externího defibrilátoru v době pandemie COVID-19.
The article provides information on selected aspects of out-of-hospital cardiac arrest in the context of the pandemic outbreak of COVID-19 disease. The impact of the pandemic on selected demographic and health characteristics is obvious especially in increase of the number of patients with out-of-hospital cardiac arrest with a dominant place of onset at home. At the time of the pandemic, a lower number of patients with an initial defibrillate rhythm and return of spontaneous circulation were reported. Furthermore, the article presents a modified algorithm for basic life support using an automated external defibrillator during the COVID-19 pandemic.
BACKGROUND: The epidemiology and outcome after out-of-hospital cardiac arrest (OHCA) varies across Europe. Following on from EuReCa ONE, the aim of this study was to further explore the incidence of and outcomes from OHCA in Europe and to improve understanding of the role of the bystander. METHODS: This prospective, multicentre study involved the collection of registry-based data over a three-month period (1st October 2017 to 31st December 2017). The core study dataset complied with the Utstein-style. Primary outcomes were return of spontaneous circulation (ROSC) and survival to hospital admission. Secondary outcome was survival to hospital discharge. RESULTS: All 28 countries provided data, covering a total population of 178,879,118. A total of 37,054 OHCA were confirmed, with CPR being started in 25,171 cases. The bystander cardiopulmonary resuscitation (CPR) rate ranged from 13% to 82% between countries (average: 58%). In one third of cases (33%) ROSC was achieved and 8% of patients were discharged from hospital alive. Survival to hospital discharge was higher in patients when a bystander performed CPR with ventilations, compared to compression-only CPR (14% vs. 8% respectively). CONCLUSION: In addition to increasing our understanding of the role of bystander CPR within Europe, EuReCa TWO has confirmed large variation in OHCA incidence, characteristics and outcome, and highlighted the extent to which OHCA is a public health burden across Europe. Unexplained variation remains and the EuReCa network has a continuing role to play in improving the quality management of resuscitation.
- MeSH
- kardiopulmonální resuscitace * MeSH
- lidé MeSH
- prospektivní studie MeSH
- registrace MeSH
- urgentní zdravotnické služby * MeSH
- zástava srdce mimo nemocnici * epidemiologie terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
PURPOSE: Functional outcomes vary between centers after out-of-hospital cardiac arrest (OHCA) and are partially explained by pre-existing health status and arrest characteristics, while the effects of in-hospital treatments on functional outcome are less understood. We examined variation in functional outcomes by center after adjusting for patient- and arrest-specific characteristics and evaluated how in-hospital management differs between high- and low-performing centers. METHODS: Analysis of observational registry data within the International Cardiac Arrest Registry was used to perform a hierarchical model of center-specific risk standardized rates for good outcome, adjusted for demographics, pre-existing functional status, and arrest-related factors with treatment center as a random effect variable. We described the variability in treatments and diagnostic tests that may influence outcome at centers with adjusted rates significantly above and below registry average. RESULTS: A total of 3855 patients were admitted to an ICU following cardiac arrest with return of spontaneous circulation. The overall prevalence of good outcome was 11-63% among centers. After adjustment, center-specific risk standardized rates for good functional outcome ranged from 0.47 (0.37-0.58) to 0.20 (0.12-0.26). High-performing centers had faster time to goal temperature, were more likely to have goal temperature of 33 °C, more likely to perform unconscious cardiac catheterization and percutaneous coronary intervention, and had differing prognostication practices than low-performing centers. CONCLUSIONS: Center-specific differences in outcomes after OHCA after adjusting for patient-specific factors exist. This variation could partially be explained by in-hospital management differences. Future research should address the contribution of these factors to the differences in outcomes after resuscitation.
- MeSH
- internacionalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- registrace statistika a číselné údaje MeSH
- senioři MeSH
- výsledek terapie * MeSH
- zástava srdce mimo nemocnici epidemiologie terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Úvod: Mimonemocniční srdeční zástava (OHCA) patří v rozvinutých zemích mezi nejčastější příčiny úmrtí dospělé populace. Centralizace poresuscitační péče může vést ke zlepšení prognózy pacientů. Společné stanovisko České kardiologické společnosti a odborných společností urgentní medicíny doporučuje zřídit centra pro diagnostiku a léčbu pacientů po OHCA mimo jiné i s využitím již existující infrastruktury sítě kardiocenter. V Libereckém kraji tento systém péče funguje od roku 2016. Cílem naší práce je prezentovat roční zkušenosti po změně organizace péče v porovnání s předchozími lety. Metody: Do registru byli konsekutivně zařazeni všichni pacienti, kteří byli léčeni v Kardiocentru Krajské nemocnice Liberec (KNL) po OHCA od 1. dubna 2016 do 1. dubna 2017. Byla sledována mortalita a neurologický stav do 30. dne od přijetí. Získaná data byla porovnána s registrem pacientů hospitalizovaných na tomto oddělení po OHCA a úspěšné resuscitaci od 1. ledna 2013 do 31. listopadu 2015. Výsledky: Po změně organizace péče došlo k nárůstu primárně transportovaných pacientů o 39,5 % (0,81 vs. 1,13 pacienta týdně). Došlo k statisticky významnému navýšení poměru pacientů s nedefibrilovatelným iniciálním rytmem (25,2 vs. 42,6 %, p = 0,013). Navzdory tomu se poměr pacientů s kardiovaskulární příčinou srdeční zástavy významně nezměnil (71,4 vs. 77,0 %). Taktéž nedošlo ke snížení podílu pacientů s akutním koronárním syndromem (47,6 vs. 44,3 %). Nedošlo k signifikantní změně počtu pacientů podstupujících selektivní koronarografii (63,9 vs. 54,1 %) a perkutánní koronární intervenci (35,4 vs. 36,1 %). Došlo k vzestupu 30denní mortality, který nebyl statisticky významný (36,7 vs. 49,2, p = 0,096). Většina přeživších pacientů (75,4 vs. 71,0 %) byla v dobrém neurologickém stavu. Závěr: Centralizace péče o pacienty po srdeční zástavě s využitím zavedené infrastruktury kardiocentra je v našem regionu proveditelná. Došlo k významnému navýšení jak primárně transportovaných pacientů, tak i celkového počtu ročně přijatých pacientů. Podíl pacientů s jinou než kardiovaskulární příčinou srdeční zástavy se nezměnil. Nedošlo k signifikantnímu zhoršení mortality či neurologického cílového ukazatele.
Introduction: Out-of-hospital cardiac arrest (OHCA) is one of the most common causes of death in the adult population in developed countries. Centralization of post-resuscitation care may improve the patients' prognosis. Expert statement of the Czech Society of Cardiology recommends the establishment of cardiac arrest centers using the infrastructure of existing tertiary cardiac centers. The introduction of this system in the region of Liberec started in April 2016. The aim of our work is to present the one-year results compared to the results from previous years. Methods: All patients treated in the Department of Cardiology of Regional Hospital Liberec after OHCA from 1st April 2016 to 1st April 2017 were enrolled consecutively. Neurological status and mortality were evaluated for the time period of 30 days from the day of admission. The data were compared to the registry of patients hospitalized in the same department after OHCA and successful resuscitation from 1st January 2013 to 31st November 2015. Results: After the establishment of the Cardiac Arrest Centre, an increase of primarily transported patients of 39.5% (0.81 vs. 1.13 patient per week) was observed. There was a statistically significant increase in the proportion of patients with non-shockable rhythm (25.2 vs. 42.6%, p = 0.013). Despite this, the proportion of patients with cardiovascular etiology of cardiac arrest did not change (71.4 vs. 77.0%). There was also no reduction in the proportion of patients with acute coronary syndrome (47.6 vs. 44.3%). There was no statistically significant change of proportion of patients undergoing selective coronarography (63.9 vs. 54.1%) and percutaneous coronary intervention (35.4 vs. 36.1%). There was an increase in 30-day mortality, which was not statistically significant (36.7 vs. 49.2%, p = 0.096). Most of the surviving patients (75.4 vs. 71.0%) were in a good neurological condition. Conclusion: Centralization of post cardiac arrest care using previously established infrastructure is feasible in our region. Furthermore, it resulted in the increase of directly transported patients and led to the increase of the total number of patients admitted without increasing the proportion of patients with a non-cardiac cause of OHCA. There was no significant change in mortality and neurological outcome.
Out-of-hospital cardiac arrest (OHCA) is a leading cause of death in developed industrial countries. The global worldwide average of OHCA incidence in adults is 95.9/100,000/year. European incidences vary according to source from 16 to 119/100,000/year. The aim of this study was to provide an overview of current information on OHCA. The incidences in various populations are discussed, along with the factors affecting the prognosis and outcome of these patients. The etiology and pathophysiological mechanisms are also described, especially in relation to the most common causes - acute and chronic forms of coronary artery disease and cardiomyopathies. Measures that could improve survival rates are discussed, with emphasis on the role of the general public and deployment of automatic external defibrillators.
- MeSH
- defibrilátory MeSH
- incidence MeSH
- lidé MeSH
- míra přežití MeSH
- prognóza MeSH
- zástava srdce mimo nemocnici epidemiologie etiologie patofyziologie terapie MeSH
- zdravotní výchova MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Cíl studie: Epidemiologie mimonemocniční náhlé zástavy oběhu (OHCA) v České republice a v Evropě není přesně známá. Proto byla realizována mezinárodní epidemiologická studie EuReCa ONE (European Registry of Cardiac Arrest) s cílem zjistit incidenci OHCA, charakteristiku procesu kardiopulmonální resuscitace (KPR) a výsledky KPR v Evropě. Studie se zúčastnila i Česká republika a v této analýze prezentujeme národní data. Typ studie: Prospektivní observační multicentrická epidemiologická studie. Typ pracoviště: Zdravotnická záchranná služba. Materiál a metoda: Studie se v České republice zúčastnily zdravotnické záchranné služby Středočeského, Královéhradeckého, Plzeňského, Karlovarského, Libereckého a Ústeckého kraje a Zdravotnická záchranná služba hlavního města Prahy. Do studie byli zařazeni všichni nemocní, kteří byli v období od 1. 10. 2014 do 31. 10. 2014 v uvedených regionech ošetřeni zdravotnickou záchrannou službou a kdykoliv během přednemocniční péče u nich byla stanovena diagnóza OHCA. Sledována a analyzována byla data v rozsahu poslední verze Utsteinského protokolu pro sledování pacientů s OHCA. Výsledky: Studie byla v České republice realizována v geografické oblasti o souhrnné populaci 4 532 758 obyvatel. Během sledovaného období byla incidence případů potvrzené OHCA s jakýmkoliv resuscitačním pokusem 98,19 případů / 100 000 obyvatel / rok. Defibrilovatelný iniciální rytmus byl zaznamenán pouze u 22,5 %. Incidence ROSC byla 30,18 případů / 100 000 obyvatel / rok. Třicetidenního přežívání anebo propuštění z nemocnice bylo dosaženo u 16,69 % všech pacientů s OHCA, u kterých byla provedena KPR, a incidence byla 16,36 případů / 100 000 obyvatel / rok. Ve všech ukazatelích byla zaznamenána klinicky relevantní mezikrajová variabilita. Závěr: Výsledky potvrzují, že OHCA je v České republice závažný zdravotnický problém s relativně vysokou incidencí a s klinicky relevantními interregionálními rozdíly.
Objective: At present, there is still a knowledge gap regarding the epidemiology of out-of-hospital cardiac arrest (OHCA) in Europe and in the Czech Republic. Therefore, the EuReCa ONE (European Registry of Cardiac Arrest) international epidemiological study was performed to determine the incidence of OHCA, the cardiopulmonary resuscitation process and OHCA outcome throughout Europe. Here we present national data from the Czech Republic. Design: Prospective, observational, multicentre, epidemiological study. Setting: Emergency medical services. Materials and methods: Emergency medical services of the Central Bohemia, Hradec Kralove, Pilsen, Karlovy Vary, Liberec and Usti nad Labem regions and the City of Prague participated in the study. All the patients who suffered an OHCA during the month of October 2014 attended by the Emergency Medical Service were eligible for inclusion in the study. The data were collected and analysed according to the latest version of the Utstein style. Results: Data covering a population of 4,532,758 inhabitants were analysed. Incidence of confirmed OHCA events with any kind of cardiopulmonary resuscitation attempt was 98.19 cases/100,000 inhabitants/year. Initial shockable rhythm was recorded in 22.5 % patients. Incidence of return of spontaneous circulation was 30.18 cases/100,000 inhabitants/year. Total 16.69 % patients survived for at least 30 days or to hospital discharge, equivalent to 16.36 cases/100,000/ inhabitants/year. Clinically relevant interregional variability was observed in all parameters. Conclusion: The results of EuReCa ONE confirm that OHCA is a major public health problem with considerable incidence and clinically relevant interregional differences.
- MeSH
- incidence MeSH
- interpretace statistických dat MeSH
- kardiopulmonální resuscitace * metody statistika a číselné údaje MeSH
- lidé MeSH
- míra přežití MeSH
- prospektivní studie MeSH
- urgentní zdravotnické služby MeSH
- výsledek terapie MeSH
- zástava srdce mimo nemocnici * epidemiologie terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- multicentrická studie MeSH
- pozorovací studie MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- antiflogistika nesteroidní * škodlivé účinky terapeutické užití MeSH
- diklofenak škodlivé účinky terapeutické užití MeSH
- hodnocení rizik MeSH
- ibuprofen škodlivé účinky terapeutické užití MeSH
- lidé MeSH
- zástava srdce mimo nemocnici epidemiologie chemicky indukované MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- klinická studie MeSH
- novinové články MeSH
