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Trends in survival after cardiac arrest: a Swedish nationwide study over 30 years

AIMS: Trends in characteristics, management, and survival in out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) were studied in the Swedish Cardiopulmonary Resuscitation Registry (SCRR). METHODS AND RESULTS: The SCRR was used to study 106 296 cases of OHCA (1990–2020) and 30...

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Autores principales: Jerkeman, Matilda, Sultanian, Pedram, Lundgren, Peter, Nielsen, Niklas, Helleryd, Edvin, Dworeck, Christian, Omerovic, Elmir, Nordberg, Per, Rosengren, Annika, Hollenberg, Jacob, Claesson, Andreas, Aune, Solveig, Strömsöe, Anneli, Ravn-Fischer, Annica, Friberg, Hans, Herlitz, Johan, Rawshani, Araz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9726448/
https://www.ncbi.nlm.nih.gov/pubmed/35924401
http://dx.doi.org/10.1093/eurheartj/ehac414
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author Jerkeman, Matilda
Sultanian, Pedram
Lundgren, Peter
Nielsen, Niklas
Helleryd, Edvin
Dworeck, Christian
Omerovic, Elmir
Nordberg, Per
Rosengren, Annika
Hollenberg, Jacob
Claesson, Andreas
Aune, Solveig
Strömsöe, Anneli
Ravn-Fischer, Annica
Friberg, Hans
Herlitz, Johan
Rawshani, Araz
author_facet Jerkeman, Matilda
Sultanian, Pedram
Lundgren, Peter
Nielsen, Niklas
Helleryd, Edvin
Dworeck, Christian
Omerovic, Elmir
Nordberg, Per
Rosengren, Annika
Hollenberg, Jacob
Claesson, Andreas
Aune, Solveig
Strömsöe, Anneli
Ravn-Fischer, Annica
Friberg, Hans
Herlitz, Johan
Rawshani, Araz
author_sort Jerkeman, Matilda
collection PubMed
description AIMS: Trends in characteristics, management, and survival in out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) were studied in the Swedish Cardiopulmonary Resuscitation Registry (SCRR). METHODS AND RESULTS: The SCRR was used to study 106 296 cases of OHCA (1990–2020) and 30 032 cases of IHCA (2004–20) in whom resuscitation was attempted. In OHCA, survival increased from 5.7% in 1990 to 10.1% in 2011 and remained unchanged thereafter. Odds ratios [ORs, 95% confidence interval (CI)] for survival in 2017–20 vs. 1990–93 were 2.17 (1.93–2.43) overall, 2.36 (2.07–2.71) for men, and 1.67 (1.34–2.10) for women. Survival increased for all aetiologies, except trauma, suffocation, and drowning. OR for cardiac aetiology in 2017–20 vs. 1990–93 was 0.45 (0.42–0.48). Bystander cardiopulmonary resuscitation increased from 30.9% to 82.2%. Shockable rhythm decreased from 39.5% in 1990 to 17.4% in 2020. Use of targeted temperature management decreased from 42.1% (2010) to 18.2% (2020). In IHCA, OR for survival in 2017–20 vs. 2004–07 was 1.18 (1.06–1.31), showing a non-linear trend with probability of survival increasing by 46.6% during 2011–20. Myocardial ischaemia or infarction as aetiology decreased during 2004–20 from 67.4% to 28.3% [OR 0.30 (0.27–0.34)]. Shockable rhythm decreased from 37.4% to 23.0% [OR 0.57 (0.51–0.64)]. Approximately 90% of survivors (IHCA and OHCA) had no or mild neurological sequelae. CONCLUSION: Survival increased 2.2-fold in OHCA during 1990–2020 but without any improvement in the final decade, and 1.2-fold in IHCA during 2004–20, with rapid improvement the last decade. Cardiac aetiology and shockable rhythms were halved. Neurological outcome has not improved.
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spelling pubmed-97264482022-12-07 Trends in survival after cardiac arrest: a Swedish nationwide study over 30 years Jerkeman, Matilda Sultanian, Pedram Lundgren, Peter Nielsen, Niklas Helleryd, Edvin Dworeck, Christian Omerovic, Elmir Nordberg, Per Rosengren, Annika Hollenberg, Jacob Claesson, Andreas Aune, Solveig Strömsöe, Anneli Ravn-Fischer, Annica Friberg, Hans Herlitz, Johan Rawshani, Araz Eur Heart J Clinical Research AIMS: Trends in characteristics, management, and survival in out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) were studied in the Swedish Cardiopulmonary Resuscitation Registry (SCRR). METHODS AND RESULTS: The SCRR was used to study 106 296 cases of OHCA (1990–2020) and 30 032 cases of IHCA (2004–20) in whom resuscitation was attempted. In OHCA, survival increased from 5.7% in 1990 to 10.1% in 2011 and remained unchanged thereafter. Odds ratios [ORs, 95% confidence interval (CI)] for survival in 2017–20 vs. 1990–93 were 2.17 (1.93–2.43) overall, 2.36 (2.07–2.71) for men, and 1.67 (1.34–2.10) for women. Survival increased for all aetiologies, except trauma, suffocation, and drowning. OR for cardiac aetiology in 2017–20 vs. 1990–93 was 0.45 (0.42–0.48). Bystander cardiopulmonary resuscitation increased from 30.9% to 82.2%. Shockable rhythm decreased from 39.5% in 1990 to 17.4% in 2020. Use of targeted temperature management decreased from 42.1% (2010) to 18.2% (2020). In IHCA, OR for survival in 2017–20 vs. 2004–07 was 1.18 (1.06–1.31), showing a non-linear trend with probability of survival increasing by 46.6% during 2011–20. Myocardial ischaemia or infarction as aetiology decreased during 2004–20 from 67.4% to 28.3% [OR 0.30 (0.27–0.34)]. Shockable rhythm decreased from 37.4% to 23.0% [OR 0.57 (0.51–0.64)]. Approximately 90% of survivors (IHCA and OHCA) had no or mild neurological sequelae. CONCLUSION: Survival increased 2.2-fold in OHCA during 1990–2020 but without any improvement in the final decade, and 1.2-fold in IHCA during 2004–20, with rapid improvement the last decade. Cardiac aetiology and shockable rhythms were halved. Neurological outcome has not improved. Oxford University Press 2022-08-04 /pmc/articles/PMC9726448/ /pubmed/35924401 http://dx.doi.org/10.1093/eurheartj/ehac414 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Clinical Research
Jerkeman, Matilda
Sultanian, Pedram
Lundgren, Peter
Nielsen, Niklas
Helleryd, Edvin
Dworeck, Christian
Omerovic, Elmir
Nordberg, Per
Rosengren, Annika
Hollenberg, Jacob
Claesson, Andreas
Aune, Solveig
Strömsöe, Anneli
Ravn-Fischer, Annica
Friberg, Hans
Herlitz, Johan
Rawshani, Araz
Trends in survival after cardiac arrest: a Swedish nationwide study over 30 years
title Trends in survival after cardiac arrest: a Swedish nationwide study over 30 years
title_full Trends in survival after cardiac arrest: a Swedish nationwide study over 30 years
title_fullStr Trends in survival after cardiac arrest: a Swedish nationwide study over 30 years
title_full_unstemmed Trends in survival after cardiac arrest: a Swedish nationwide study over 30 years
title_short Trends in survival after cardiac arrest: a Swedish nationwide study over 30 years
title_sort trends in survival after cardiac arrest: a swedish nationwide study over 30 years
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9726448/
https://www.ncbi.nlm.nih.gov/pubmed/35924401
http://dx.doi.org/10.1093/eurheartj/ehac414
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