Journal of the American Heart Association
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Multicenter Study Comparative Study
Sensitivity, specificity, and sex differences in symptoms reported on the 13-item acute coronary syndrome checklist.
Clinical symptoms are part of the risk stratification approaches used in the emergency department (ED) to evaluate patients with suspected acute coronary syndromes (ACS). The objective of this study was to determine the sensitivity, specificity, and predictive value of 13 symptoms for a discharge diagnosis of ACS in women and men. ⋯ There were more similarities than differences in symptom predictors of ACS for women and men.
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Multicenter Study Comparative Study
Hospital variation in survival after in-hospital cardiac arrest.
In-hospital cardiac arrest (IHCA) is common and often fatal. However, the extent to which hospitals vary in survival outcomes and the degree to which this variation is explained by patient and hospital factors is unknown. ⋯ Significant variability in IHCA survival exists across hospitals, and this variation persists despite adjustment for measured patient factors and within hospital subgroups. These findings suggest that other hospital factors may account for the observed site-level variations in IHCA survival.
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Multicenter Study Observational Study
Bedside tool for predicting the risk of postoperative atrial fibrillation after cardiac surgery: the POAF score.
Atrial fibrillation (AF) remains the most common complication after cardiac surgery. The present study aim was to derive an effective bedside tool to predict postoperative AF and its related complications. ⋯ The POAF score is a simple, accurate bedside tool to predict postoperative AF and its related or accompanying complications.
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Multicenter Study
Thrombolysis delivery by a regional telestroke network--experience from the U.K. National Health Service.
The majority of established telestroke services are based on "hub-and-spoke" models for providing acute clinical assessment and thrombolysis. We report results from the first year of the successful implementation of a locally based telemedicine network, without the need of 1 or more hub hospitals, across a largely rural landscape. ⋯ We demonstrate the safety and effectiveness of a horizontal networking approach for stroke telemedicine, which may be applicable to areas where traditional "hub-and-spoke" models may not be geographically feasible.