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Aim To compare the incidence and percentage of survival after cardiac arrest outside and inside hospital where cardiopulmonary resuscitation (CPR) had been started between two regions in Sweden in a 10-year perspective. Methods A retrospective observational study including CPR treated patients both after out-of-hospital and in-hospital cardiac arrest (OHCA and IHCA) in Sweden, 2013–2022. Data was retrieved from the Swedish Registry of Cardiopulmonary Resuscitation (SRCR). Results The overall incidence of OHCA and IHCA events were 2,940 in Dalarna (having a lower population and population density) and 16,187 in Västra Götaland (having a higher population and population density). The overall incidence of survival when OHCA and IHCA were combined was 20 per 100,000 person years in Dalarna and 19 per 100,000 person years in Västra Götaland. The corresponding result for OHCA was 9 versus 7 and for IHCA 11 versus 12. The overall percentage of survival was 20% in Dalarna and 19% in Västra Götaland. The corresponding result for OHCA was 13% versus 10% and for IHCA 37% versus 36%. Conclusion Overall, there was no marked difference neither in incidence nor in percentage of survival after cardiac arrest between the two regions. However, regarding cardiac arrest that took place outside hospital both incidence and percentage of survival was higher in Dalarna than in Västra Götaland despite the fact that the former had lower population density.

The study aimed to describe how breathlessness is experienced by patients prior to prehospital care.A qualitative phenomenological design.Lifeworld interviews were conducted with 14 participants. The analysis was carried out within the descriptive phenomenological framework.The essential meaning of the breathlessness phenomenon is described as an existential fear in terms of losing control over one's body and dying, which involves a battle to try to regain control. This is further described by four constituents: being in an unknown body, striving to handle the situation, the ambiguity of having loved ones close and reaching the utmost border.Patients describe a battling for survival. It is at the extreme limit of endurance that patients finally choose to call the emergency number. It is a challenge for the ambulance clinician (AC) to support these patients in the most optimal fashion.© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.

Background Characteristics and prognosis of patients admitted with strong suspicion of myocardial infarction (MI) but discharged without an MI diagnosis are not well-described. Objectives To compare background characteristics and cardiovascular outcomes in patients discharged with or without MI diagnosis. Methods The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial compared 6629 patients with strong suspicion of MI randomized to oxygen or ambient air. The main composite end-point of this subgroup analysis was the incidence of all-cause death, rehospitalization with MI, heart failure (HF) or stroke during a follow-up of 2.1 years (median; range: 1-3.7 years) irrespective of randomized treatment. Results 1619 (24%) received a non-MI discharge diagnosis, and 5010 patients (76%) were diagnosed with MI. Groups were similar in age, but non-MI patients were more commonly female and had more comorbidities. At thirty days, the incidence of the composite end-point was 2.8% (45 of 1619) in non-MI patients, compared to 5.0% (250 of 5010) in MI patients with lower incidences in all individual end-points. However, for the long-term follow-up, the incidence of the composite end-point increased in the non-MI patients to 17.7% (286 of 1619) as compared to 16.0% (804 of 5010) in MI patients, mainly driven by a higher incidence of all-cause death, stroke and HF. Conclusions Patients admitted with a strong suspicion of MI but discharged with another diagnosis had more favourable outcomes in the short-term perspective, but from one year onwards, cardiovascular outcomes and death deteriorated to a worse long-term prognosis., Funding Agencies|Swedish HeartLung FoundationSwedish Heart-Lung Foundation [HLF20160688, HLF20180187]; Stockholm County CouncilStockholm County Council [K 20174577]; Swedish Heart-Lung FoundationSwedish Heart-Lung Foundation [HLF20180287]

Background: There is a knowledge gap regarding aetiology of and potential for predicting out-of-hospital cardiac arrest (OHCA) among individuals whoare healthy before the event.Aim: To describe causes of OHCA and the potential for predicting OHCA in apparently healthy patients.Methods: Patients were recruited from the Swedish Register of Cardiopulmonary Resuscitation from November 2007 to January 2011. Inclusioncriteria were: OHCA with attempted CPR but neither dispensed prescription medication nor hospital care two years before the event The registerincludes the majority of patients suffering OHCA in Sweden where cardiopulmonary resuscitation (CPR) was attempted. Medication status was definedby linkage to the Swedish Prescribed Drug Register. Cause of death was assessed based on autopsy and the Swedish Cause of Death Register.Prediction of OHCA was attempted based on available electrocardiograms (ECG) before the OHCA event.Results: Altogether 781 individuals (16% women) fulfilled the inclusion criteria. Survival to 30 days was 16%. Autopsy rate was 72%. Based on autopsy,70% had a cardiovascular aetiology and 59% a cardiac aetiology. An ECG recording before the event was found in 23% of cases. The ECG wasabnormal in 22% of them.Conclusion: Among OHCA victims who appeared to be healthy prior to the event, the cause was cardiovascular in the great majority according toautopsy findings. A minority had a preceding abnormal ECG that could have been helpful in avoiding the event.