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Out-of-hospital cardiac arrests in young adults in Melbourne, Australia-adding coronial data to a cardiac arrest registry
- Source :
- Resuscitation. 82(10)
- Publication Year :
- 2011
-
Abstract
- Aim: We aim to describe the coronial findings of young adults where the out-of-hospital cardiac arrest (OHCA) aetiology was 'presumed cardiac'. Discussion: Linking OHCA registries with coronial databases for aetiology of the arrest will improve the quality of the data and should be considered by all OHCA registries, particularly for young adult OHCA. Methods: Presumed cardiac aetiology OHCAs occurring in young adults aged 16-39 years were identified using the Victorian Ambulance Cardiac Arrest Registry (VACAR) and available coronial findings reviewed. Results: We identified 841 young adult OHCAs where the Utstein aetiology was 'presumed cardiac'. Of these 740 died and 572 (77%) OHCAs were matched to coroner's findings. On review of the coroner's cause of death, 230 (40.2%) had a 'confirmed cardiac' aetiology, 221 (38.6%) were proven 'non-cardiac', 97 (17%) were inconclusive and 24 (4.2%) cases remained 'open'. 'Confirmed cardiac' causes of OHCA were ischemic heart disease (n = 126, 55%), cardiomegaly (n = 26, 11.3%), cardiomyopathy (n = 25, 11%), congenital heart disease (n = 15, 6.5%), cardiac tamponade due to dissecting thoracic aorta aneurysm (n = 10, 4.3%), myocarditis (n = 8, 3.5%), arrhythmia (n = 7, 3%), others (n = 13, 5.7%). 'Non-cardiac' causes of OHCA were epilepsy/sudden unexplained death in epilepsy (SUDEP) (n = 56, 25%), pulmonary embolism (n = 29, 13%), subarachnoid haemorrhage (n = 17, 7.7%), other intracranial bleed (n = 7, 3.2%), pneumonia (n = 17, 7.7%), DKA (n = 16, 7.2%), other complications of diabetes mellitus (n = 8, 3.6%), complications of obesity (n = 9, 4%), haemorrhage (n = 12, 5.4%), sepsis (n = 8, 3.6%), peritonitis (n = 6, 2.7%), aspiration (n = 6, 2.7%), renal failure (n = 5, 2.3%), asthma (n = 5, 2.3%), complications of anorexia (n = 3) and alcohol abuse (n =2), thyrotoxicosis (n = 2), meningitis (n = 1) and others (n = 12). Compared with coroner's diagnosed 'non-cardiac' OHCAs, 'confirmed cardiac' were more likely to be witnessed (41% vs 23%, p ≤ 0.01), receive bystander CPR (35% vs 20%, p ≤ 0.001), have a shockable rhythm (27% vs 6.3%, p < 0.001) and have EMS attempted resuscitation (62% vs 44%, p < 0.001). Refereed/Peer-reviewed
- Subjects :
- young adults
Adult
Male
medicine.medical_specialty
Myocarditis
Heart disease
Adolescent
medicine.medical_treatment
Cardiomyopathy
cardiac arrest
Emergency Nursing
cardiopulmonary resuscitation
Young Adult
autopsy
Internal medicine
Cardiac tamponade
coroner
medicine
Humans
Cardiopulmonary resuscitation
Registries
Cause of death
Retrospective Studies
business.industry
EMS
Australia
out-of-hospital
medicine.disease
Pulmonary embolism
Emergency Medicine
Cardiology
Etiology
CPR
Female
Cardiology and Cardiovascular Medicine
business
Coroners and Medical Examiners
Out-of-Hospital Cardiac Arrest
Subjects
Details
- ISSN :
- 18731570
- Volume :
- 82
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Resuscitation
- Accession number :
- edsair.doi.dedup.....c5a521fc7eb033a1c08a625182823543