Ann Acad Med Singap
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Ann Acad Med Singap · Jul 2010
Are new resuscitation guidelines better? Experience of an Asian metropolitan hospital.
Cardiopulmonary resuscitation (CPR) guidelines were revised in 2005 based on new evidence and expert consensus. However, the benefits of the new guidelines remain undetermined and their influence has not been published in Asia. This study aimed to evaluate the impact of implementing the new resuscitation guidelines and identify factors that influence the discharge survival of out-of-hospital cardiac arrest (OHCA) patients in an Asian metropolitan city. ⋯ We did not observe any improvement in survival after implementing the new guidelines. Independent factors of survival-to-hospital discharge are witnessed arrest and initial rhythm with VF/pulseless VT. Because the rates of VF/pulseless VT and bystander CPR in Asia are low, popularising CPR training programmes and increasing the rate of bystander CPR may be more important for improving OHCA survival rates than frequent guideline changes.
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Exercise-related cardiac arrest is uncommon, however it is devastating when it occurs in otherwise healthy adults. This study aims to identify the characteristics of exercise-related cardiac arrest in the study population and estimate the overall survival rate. ⋯ We found that exercise-related cardiac arrest causes significant mortality in our community. Increased CPR training among the public, easy access to defibrillators and faster emergency medical service (EMS) response time could improve the outcome of exercise-related cardiac arrests. A comprehensive pre-participation screening for competitive exercises should be outlined for primary prevention of exercise-related cardiac arrest. A better reporting system for exercise-related cardiac arrest is needed.
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Ann Acad Med Singap · Jun 2010
Incidence, mortality and five-year relative survival ratio of prostate cancer among Chinese residents in Singapore from 1968 to 2002 by metastatic staging.
This paper examines the incidence, mortality and survival patterns among all Chinese residents with prostate cancer reported to the Singapore Cancer Registry in Singapore from 1968 to 2002 by metastatic staging. ⋯ Both age-standardised incidence and mortality rates for prostate cancer among Chinese Singapore residents are still on the rise especially since the 1990s. Since the 1990s, the improvement in RSRs was substantial for the Chinese non-metastatic cases.
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Ann Acad Med Singap · Jun 2010
Evaluation of intensive care unit-acquired urinary tract infections in Singapore.
Urinary tract infections remain one of the most frequently encountered acquired complications in an intensive care unit (ICU). The objective of this study was to determine the incidence, risk factors, microbial sensitivity patterns, and clinical outcomes of patients with UTIs acquired during their admission to an ICU in an acute care hospital in Singapore. ⋯ The incidence of ICU-acquired UTIs was similar to figures reported for nosocomial UTIs from the previous studies. Significant risk factors for developing an ICU-acquired UTI were female gender and history of antibiotic exposure prior to ICU admission. The insignificant link between ICU-acquired UTI and mortality requires further investigation in larger cohorts.
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Ann Acad Med Singap · Jun 2010
Central clot score at computed tomography as a predictor of 30-day mortality after acute pulmonary embolism.
The severity of acute pulmonary embolism can be assessed with computed tomography (CT) using clot burden estimation. We compared the existing CT obstruction scores with an in-house developed central clot score for the prediction of 30-day pulmonary embolism (PE)-related mortality. ⋯ Central clot score is a strong predictor of 30-day PE death and may therefore allow therapy and risk stratification in patients with acute PE.