Association of High-Volume Centers With Survival Outcomes Among Patients With Nontraumatic Out-of-Hospital Cardiac Arrest

Goh, Amelia Xin Chun; Seow, Jie Cong; Lai, Melvin Yong Hao; Liu, Nan; Goh, Yi Man; Ong, Marcus Eng Hock; Lim, Shir Lynn; Ho, Jean K.; Yeo, Jun Wei; Ho, Andrew Fu Wah

doi:10.1001/jamanetworkopen.2022.14639

Cited by 10 publications

(6 citation statements)

References 36 publications

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“…We included for follow‐up both patients with OHCA who survived to 30 days or who survived to hospital discharge regardless of time from index event, since using either time point reflects up to 99.6% similarity in long‐term survival rates and is an approach previously used in published studies. 20 , 21 All follow‐up periods and incidence of AMI outcomes were calculated from the baseline of either 30 days or discharge after OHCA, depending on whichever time point was earlier for each patient. We applied the following exclusion criteria: patients who were (1) foreigners, (2) aged <18 years, or (3) pronounced dead on the scene or at the emergency department.…”

Section: Methodsmentioning

confidence: 99%

Incidence and Long‐Term Outcomes of Acute Myocardial Infarction Among Survivors of Out‐of‐Hospital Cardiac Arrest

Ho,

Zheng,

et al. 2024

JAHA

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Background Despite the increasing long‐term survival after out‐of‐hospital cardiac arrest (OHCA), the risk of subsequent acute myocardial infarction (AMI) remains poorly understood. We aimed to determine the incidence, predictors, and long‐term outcomes of AMI among survivors of OHCA. Methods and Results We assembled a retrospective cohort of 882 patients with OHCA who survived to 30 days or discharge from the hospital between 2010 and 2019. Survivors of OHCA had an increased risk of subsequent AMI, defined as AMI occurring 30 days after index OHCA or following discharge from the hospital after OHCA, compared with the general population when matched for age and sex (standardized incidence ratio, 4.64 [95% CI, 3.52–6.01]). Age‐specific risks of subsequent AMI for men (standardized incidence ratio, 3.29 [95% CI, 2.39–4.42]) and women (standardized incidence ratio, 6.15 [95% CI, 3.27–10.52]) were significantly increased. A total of 7.2%, 8.3%, and 14.3% of survivors of OHCA had a subsequent AMI at 3 years, 5 years, and end of follow‐up, respectively. Age at OHCA (hazard ratio [HR], 1.04 [95% CI, 1.02–1.06]) and past medical history of prior AMI, defined as any AMI preceding or during the index OHCA event (HR, 1.84 [95% CI, 1.05–3.22]), were associated with subsequent AMI, while an initial shockable rhythm was not (HR, 1.00 [95% CI, 0.52–1.94]). Survivors of OHCA with subsequent AMI had a higher risk of death (HR, 1.58 [95% CI, 1.12–2.22]) than those without. Conclusions Survivors of OHCA are at an increased risk of subsequent AMI compared with the general population. Prior AMI, but not an initial shockable rhythm, increases this risk, while subsequent AMI predicts death. Preventive measures for AMI including cardiovascular risk factor control and revascularization may thus improve outcomes in selected patients with cardiac pathogenesis.

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Section: Methodsmentioning

confidence: 99%

Incidence and Long‐Term Outcomes of Acute Myocardial Infarction Among Survivors of Out‐of‐Hospital Cardiac Arrest

Ho,

Zheng,

et al. 2024

JAHA

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“…Even for oncological surgeries, “high-volume” has been variable, with studies reporting 20-35 cases annually as cut-off for pancreas resection[ 89 , 90 ]. In contrary, studies which reported on outcomes of out-of-hospital cardiac arrest defined high-volume as ≥ 40-100 cases annually[ 91 ]. For AP, there is no literature on what defines “high-volume”.…”

Section: Management Of Non-mild Apmentioning

confidence: 99%

Diagnosis, severity stratification and management of adult acute pancreatitis–current evidence and controversies

Chan¹,

Shelat²

2022

World J Gastrointest Surg

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Acute pancreatitis (AP) is a disease spectrum ranging from mild to severe with an unpredictable natural course. Majority of cases (80%) are mild and self-limiting. However, severe AP (SAP) has a mortality risk of up to 30%. Establishing aetiology and risk stratification are essential pillars of clinical care. Idiopathic AP is a diagnosis of exclusion which should only be used after extended investigations fail to identify a cause. Tenets of management of mild AP include pain control and management of aetiology to prevent recurrence. In SAP, patients should be resuscitated with goal-directed fluid therapy using crystalloids and admitted to critical care unit. Routine prophylactic antibiotics have limited clinical benefit and should not be given in SAP. Patients able to tolerate oral intake should be given early enteral nutrition rather than nil by mouth or parenteral nutrition. If unable to tolerate per-orally, nasogastric feeding may be attempted and routine post-pyloric feeding has limited evidence of clinical benefit. Endoscopic retrograde cholangiopancreatogram should be selectively performed in patients with biliary obstruction or suspicion of acute cholangitis. Delayed step-up strategy including percutaneous retroperitoneal drainage, endoscopic debridement, or minimal-access necrosectomy are sufficient in most SAP patients. Patients should be monitored for diabetes mellitus and pseudocyst.

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“…One major reason for the inconclusive results on this topic may be the varying degrees of centralization of hospital functions in different countries. Thus, recent systematic reviews and meta-analyses have also not reached certain conclusions [ 4 , 5 ]. In fact, the heterogeneity of studies used in these systematic reviews and meta-analyses is high.…”

Section: Commentmentioning

confidence: 99%

Author Response Letter: “Correspondence: Is there an association between centre volume and survival or neurological outcomes among out-of-hospital cardiac arrest patients?”

Tsuchida

Hayakawa

2022

BMC Emerg Med

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Association of High-Volume Centers With Survival Outcomes Among Patients With Nontraumatic Out-of-Hospital Cardiac Arrest

Cited by 10 publications

References 36 publications

Incidence and Long‐Term Outcomes of Acute Myocardial Infarction Among Survivors of Out‐of‐Hospital Cardiac Arrest

Incidence and Long‐Term Outcomes of Acute Myocardial Infarction Among Survivors of Out‐of‐Hospital Cardiac Arrest

Diagnosis, severity stratification and management of adult acute pancreatitis–current evidence and controversies

Author Response Letter: “Correspondence: Is there an association between centre volume and survival or neurological outcomes among out-of-hospital cardiac arrest patients?”

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