7 research outputs found
Contacts With the Health Care System Before Out-of-Hospital Cardiac Arrest
BACKGROUND: It remains challenging to identify patients at risk of outâofâhospital cardiac arrest (OHCA). We aimed to examine health care contacts in patients before OHCA compared with the general population that did not experience an OHCA. METHODS AND RESULTS: Patients with OHCA with a presumed cardiac cause were identified from the Danish Cardiac Arrest Registry (2001â2014) and their health care contacts (general practitioner [GP]/hospital) were examined up to 1Â year before OHCA. In a caseâcontrol study (1:9), OHCA contacts were compared with an ageâ and sexâmatched background population. Separately, patients with OHCA were examined by the contact type (GP/hospital/both/no contact) within 2Â weeks before OHCA. We included 28Â 955 patients with OHCA. The weekly percentages of patient contacts with GP the year before OHCA were constant (25%) until 1Â week before OHCA when they markedly increased (42%). Weekly percentages of patient contacts with hospitals the year before OHCA gradually increased during the last 6Â months (3.5%â6.6%), peaking at the second week (6.8%) before OHCA; mostly attributable to cardiovascular diseases (21%). In comparison, there were fewer weekly contacts among controls with 13% for GP and 2% for hospital contacts (P<0.001). Within 2Â weeks before OHCA, 57.8% of patients with OHCA had a health care contact, and these patients had more contacts with GP (odds ratio [OR], 3.17; 95% CI, 3.09â3.26) and hospital (OR, 2.32; 95% CI, 2.21â2.43) compared with controls. CONCLUSIONS: The health care contacts of patients with OHCA nearly doubled leading up to the OHCA event, with more than half of patients having health care contacts within 2Â weeks before arrest. This could have implications for future preventive strategies
Prodromal symptoms of out-of-hospital cardiac arrest among patients calling emergency and non-emergency medical help services
Registered prodromal symptoms of out-of-hospital cardiac arrest among patients calling the medical helpline services
Background Early identification of warning symptoms among out-of-hospital cardiac arrest (OHCA) patients remains challenging. Thus, we examined the registered prodromal symptoms of patients who called medical helpline services within 30-days before OHCA. Methods Patients unwitnessed by emergency medical services (EMS) aged âĽ18 years during their OHCA were identified from the Danish Cardiac Arrest Registry (2014â2018) and linked to phone records from the 24-h emergency helpline (1â1â2) and out-of-hours medical helpline (1813-Medical Helpline) in Copenhagen before the arrest. The registered symptoms were categorized into chest pain; breathing problems; central nervous system (CNS)-related/unconsciousness; abdominal/back/urinary; psychiatric/addiction; infection/fever; trauma/exposure; and unspecified (diverse from the beforementioned categories). Analyses were divided by the time-period of calls (0-7 days/8-30 days preceding OHCA) and call type (1â1-2/1813-Medical Helpline). Results Of all OHCA patients, 18% (974/5442) called helpline services (males 56%, median age 76 years[Q1-Q3:65â84]). Among these, 816 had 1145 calls with registered symptoms. The most common symptom categories (except for unspecified, 33%) were breathing problems (17%), trauma/exposure (17%), CNS/unconsciousness (15%), abdominal/back/urinary (12%), and chest pain (9%). Most patients (61%) called 1813-Medical Helpline, especially for abdominal/back/urinary (17%). Patients calling 1â1-2 had breathing problems (24%) and CNS/unconsciousness (23%). Nearly half of the patients called within 7 days before their OHCA, and CNS/unconsciousness (19%) was the most registered. The unspecified category remained the most common during both time periods (32%;33%) and call type (24%;39%). Conclusions Among patients who called medical helplines services up to 30-days before their OHCA, besides symptoms being highly varied (unspecified (33%)), breathing problems (17%) were the most registered symptom-specific category