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Twenty-year trends in the characteristic, management and outcome of patients with ST-elevation myocardial infarction and out-of-hospital reanimation. Insight from the national AMIS PLUS registry 1997-2017.
- Source :
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Resuscitation . Jan2019, Vol. 134, p55-61. 7p. - Publication Year :
- 2019
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Abstract
- <bold>Background: </bold>Few studies describe recent changes in the incidence, treatment and outcome of successfully resuscitated STEMI patients after out-of-hospital cardiac arrest (OHCA) compared with non-OHCA STEMI patients.<bold>Objective: </bold>To examine temporal trends in the incidence, therapeutic management, most serious complications, mortality rate and outcome of OHCA patients fulfilling criteria of STEMI compared with a reference group of STEMI patients without OHCA.<bold>Methods: </bold>Analysis of registry data (AMIS Plus Registry) among STEMI patients both with and without OHCA between 1997 and 2017.<bold>Results: </bold>Among 31,650 patients with STEMI, 6.8% were successfully resuscitated prior to hospital admission. Increasing incidences of hospital-admitted patients following successful out-of-hospital CPR were observed (4.5% in 1999 vs. 8.6% in 2017). OHCA STEMI patients were at higher clinical risk at presentation (36.1% vs. 2.7%; p < 0.001 with cardiogenic shock) despite a shorter time span from the onset of symptoms to hospitalization (195 min vs. 107 min; p < 0.001) and a lower prevalence of cardiovascular risk factors except smoking. More PCIs were performed in STEMI patients with OHCA (78.9% vs. 74.5% for non-OHCA patients; p < 0.001). However, over time PCI became the preferred primary intervention irrespective of the OHCA status of STEMI patients. For STEMI patients without OHCA, there was a significant correlation between PCI and time periods on in-hospital mortality (p < 0.001), which was p = 0.002 when adjusted for age and gender. For STEMI patients with OHCA, the interaction between PCI and time was unadjusted p = 0.395 and p = 0.438 when adjusted for age and gender. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CARDIAC resuscitation
*MYOCARDIAL infarction
*HOSPITAL patients
*MORTALITY
*CARDIOPULMONARY resuscitation
*CARDIOGENIC shock
*CARDIOVASCULAR system
*INDUCED hypothermia
*LONGITUDINAL method
*MEDICAL care
*PATIENTS
*TREATMENT effectiveness
*ACQUISITION of data
*CASE-control method
*HOSPITAL mortality
Subjects
Details
- Language :
- English
- ISSN :
- 03009572
- Volume :
- 134
- Database :
- Academic Search Index
- Journal :
- Resuscitation
- Publication Type :
- Academic Journal
- Accession number :
- 134688218
- Full Text :
- https://doi.org/10.1016/j.resuscitation.2018.11.010