National Data of CPR Procedures Performed on Hospitalized Thai Older Population Patients

Background: Little is known about the epidemiology of the elderly who receive cardiopulmonary resuscitation (CPR) and the subsequent survival factors in Thailand and other developing countries. The objective of this study was to determine the rate of CPR and the survival rate among hospitalized Thai elderly patients, and also factors predicting survival at discharge. Methods: National databases from three sources were searched. These three systems accounted for 96% of the Thai population. All inpatients in the fiscal year 2010 (from October 1, 2009 to September 31, 2010) aged 60 years or over who received CPR procedure were included. Baseline characteristics were studied. The study outcomes were CPR rate, mortality rate, and survival factors. Results: In total, 17,813 elderly patients who were hospitalized during the 2010 fiscal year received CPR (997.2/100,000 older adults). Of those, 5125 patients (28.77%) survived at discharge. Pre-existing comorbidity, asystole, time on a mechanical ventilator > 96 hours, and being admitted to a private hospital were associated with poorer outcomes (p < 0.05). Conclusion: The rate of CPR in hospitalized elderly patients was 997.2 events/100,000 older adults with a survival rate of 28.77%. Factors predicting death at discharge are pre-existing comorbidities, cardiac arrhythmia type, intervention/procedure, and type of hospital

Impact of the adjunctive use criteria for intravascular ultrasound-guided percutaneous coronary intervention and clinical outcomes

Abstract The impact of the adherence to the adjunctive use criteria (AUC) for intravascular ultrasound (IVUS) guided percutaneous coronary intervention (PCI) and clinical outcomes in low IVUS volume countries are limited. The current study compared the procedural success and complication rates between used and not used IVUS catheter in the patients who were met (C +) and were not met (C−) the AUC for IVUS-guided PCI. From June 2018 through June 2019, a total of 21,066 patients were included in the Thai PCI registry. Among the study population, 15,966 patients (75.8%) have met the IVUS-AUC. The IVUS-guided PCI rates were 14.5% and 11.3% in the C + and C − groups, respectively. After adjusting for covariables by propensity model, IVUS-guided PCI was identified as an independent predictor of the procedural success rate regardless of whether the AUC were met with the relative risk [RR (95% confidence interval (CI)] of 1.033(1.026–1.040) and 1.012(1.002–1.021) in C + and C− groups, respectively. IVUS-guided PCI increased the procedural complication risks in both groups but were not significant with corresponding RRs of 1.171(0.915–1.426) and 1.693(0.959–2.426). Procedural success was achieved with IVUS-guided PCI regardless of whether the AUC were met. IVUS-guided PCI did not lead to an increase in procedural complications

Sex differences in patients undergoing transcatheter aortic valve replacement in Asia

Objectives Transcatheter aortic valve replacement (TAVR) is increasingly performed. Physically small Asians have smaller aortic root and peripheral vessel anatomy. The influence of gender of Asian patients undergoing TAVR is unknown and may affect outcomes. The aim of this study was to assess sex differences in Asian patients undergoing TAVR.Methods Patients undergoing TAVR from eight countries were enrolled. In this retrospective analysis, we examined differences in characteristics, 30-day clinical outcomes and 1-year survival between female and male Asian patients.Results Eight hundred and seventy-three patients (54.4% women) were included. Women were older, smaller and had less coronary artery and lung disease but tended to have higher logistic EuroSCOREs. Smaller prostheses were used more often in women. Major vascular complications occurred more frequently in women (5.5% vs 1.8%, p&lt;0.01); however, 30-day stroke and mortality (women vs men: 1.5% vs 1.6%, p=0.95% and 4.3% vs 3.4%, p=0.48) were similar. Functional status improvement was significant and comparable between the sexes. Conduction disturbance and permanent pacemaker requirements (11.2% vs 9.0%, p=0.52) were also similar as was 1-year survival (women vs men: 85.6% vs 88.2%, p=0.25). The only predictors of 30-day mortality were major vascular injury in women and age in men.Conclusions Asian women had significantly smaller stature and anatomy with some differences in clinical profiles. Despite more frequent major vascular complications, women had similar 30-day stroke or mortality rates. Functional status improvement was significant and comparable between the sexes. Conduction disturbance and permanent pacemaker requirements were similar as was 1-year survival