Resuscitation
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No European data currently describe the relation between neighbourhood socio-economic status (SES) and rates of out-of-hospital cardiac arrest (OHCA) bystander cardiopulmonary resuscitation (CPR). This study aims to analyse this effect with a robust deprivation index. ⋯ In the city of Paris, OHCA victims were less likely to receive bystander CPR in low SES neighbourhoods. These first European data are consistent with observations in North America and Asia.
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Prognosticating outcome following cardiac arrest is challenging and requires a multimodal approach. We tested the hypothesis that the combination of initial neurologic examination, quantitative analysis of head computed tomography (CT) and continuous EEG (cEEG) improve outcome prediction after cardiac arrest. ⋯ Combining GWR with cEEG was superior to any individual test for predicting mortality and neurologic outcome. Addition of clinical variables further improved prognostication for mortality but not neurologic outcome. These preliminary data support a multi-modal prognostic workup in this population.
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Observational Study
Epidemiology and outcomes from out-of-hospital cardiac arrests in England.
This study reports the epidemiology and outcomes from out-of-hospital cardiac arrest (OHCA) in England during 2014. ⋯ Cardiac arrest is an important cause of death in England. With less than one in ten patients surviving, there is scope to improve outcomes. Survival rates were highest amongst those who received bystander CPR and public access defibrillation.
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The use of electroencephalogram (EEG) has been demonstrated to have diagnostic and prognostic value in cardiac arrest patients. The use of this modality across the United States in this population is unknown. ⋯ EEG is performed on approximately 2% of patients who suffer cardiac arrest in the United States. The treatment hospital and patient characteristics of those who received an EEG different from those who did not.
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Comorbid conditions have been associated with morbidity, functional status and quality of life for patients with a wide range of diseases. Previous studies have attempted to elucidate the influence of pre-arrest comorbidities on survival and neurological recovery following out-of-hospital cardiac arrest (OHCA), however the findings are conflicting. ⋯ Consideration of a patient's baseline comorbidity may assist prognostication decisions for cardiac arrest patients. Exploration of the effect of additional rehabilitation on HR-QOL and long-term survival outcomes for OHCA patients with a high baseline comorbidity burden may be warranted.