Resuscitation
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Multicenter Study
Development and validation of risk models to predict outcomes following in-hospital cardiac arrest attended by a hospital-based resuscitation team.
The National Cardiac Arrest Audit (NCAA) is the UK national clinical audit for in-hospital cardiac arrest. To make fair comparisons among health care providers, clinical indicators require case mix adjustment using a validated risk model. The aim of this study was to develop and validate risk models to predict outcomes following in-hospital cardiac arrest attended by a hospital-based resuscitation team in UK hospitals. ⋯ Validated risk models for ROSC>20min and hospital survival following in-hospital cardiac arrest have been developed. These models will strengthen comparative reporting in NCAA and support local quality improvement.
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Observational Study
Long term trends in Medical Emergency Team activations and outcomes.
. To analyze long-term medical emergency team (MET) operational trends including number of MET calls, trigger criteria for activation and clinical outcomes at a tertiary level, university hospital with a mature MET system. ⋯ MET activity progressively increased during the study period and there was a change in pattern of specific triggering criteria. The sustained decrease in hospital mortality independent of cardiac arrest and unplanned ICU admissions rates suggests patient benefit from the MET system.
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Multicenter Study
Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit.
To report the incidence, characteristics and outcome of adult in-hospital cardiac arrest in the United Kingdom (UK) National Cardiac Arrest Audit database. ⋯ These first results from the NCAA database describing the current incidence and outcome of adult in-hospital cardiac arrest in UK hospitals will serve as a benchmark from which to assess the future impact of changes in service delivery, organisation and treatment for in-hospital cardiac arrest.
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Neuron specific enolase (NSE) and astroglial protein S100B are associated with outcome following resuscitation from cardiac arrest. We tested whether NSE and S100B levels are associated with illness severity on hospital arrival, and whether levels are independently associated with survival to hospital discharge after adjusting for initial illness severity. ⋯ More severe neurologic injury on initial examination is associated with higher levels of NSE and S100B. Elevated levels of S100B immediately following resuscitation were associated with death. Persistently elevated levels of NSE and S100B at 48 and 72h were associated with death.