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At least 973 records · Page 54Linked to original sources
PubMed1998

Fatality outside hospital from acute coronary events in three British health districts, 1994-5. United Kingdom Heart Attack Study Collaborative Group.

OBJECTIVES: To provide a contemporary account of the treatment and outcomes of acute coronary attacks in England and Wales and to identify strategies that might improve the outcome. DESIGN: Two year community and hospital based study in three British health districts. SETTING: Health districts of Brighton (population 282,000), South Glamorgan (408,000), and York (264,000). SUBJECTS: 3523 men and women under 75 years of age who died outside hospital from acute coronary causes, who were admitted to hospital with acute myocardial infarction, or who developed acute infarction or died unexpectedly from acute coronary causes while they were already in hospital. INTERVENTIONS: Attempted resuscitation in people having a cardiac arrest outside hospital. MAIN OUTCOME MEASURES: Total case fatality, case fatality outside and inside hospital, and the effect of resuscitation on case fatality outside hospital. RESULTS: 1589 patients died within 30 days of the acute event. Case fatality was 45% (95% confidence interval 43% to 47%), rising from 27% (160/595) (23% to 31%) at age < 55 years to 53% (1019/1916) (51% to 55%) at 65-74 years. Overall, 74% (1172/1589) (72% to 76%) of fatal events happened outside hospital, and there was a negative age gradient (P < 0.001) such that 91% (145/160) (87% to 95%) of fatalities occurred outside hospital at age < 55 compared with 70% (710/1019) (67% to 73%) at 65-74 years. Without successful resuscitation of 55 patients outside hospital, total case fatality at 30 days would have risen from 45% to 46.7%. CONCLUSION: Opportunities for reducing fatality from acute coronary attacks lie mainly outside hospital. These results and others imply that survival from cardiac arrest outside hospital might be trebled by improved ambulance and patient response. Proper application of secondary preventive measures for patients with coronary disease could have an even larger impact.

Adult↗
PubMed1998

The concept and the development of chest pain emergency departments as a strategy in the war against heart attack.

Critical nurses in the CPED can have a very fulfilling role in expanding their influence within the hospital setting, as well as within the community to become part of the needed change to significantly reduce deaths from MI in the United States. The mission impossible becomes possible when critical care nurses are part of this challenging process. Nowhere can these efforts be better started than in emergency department committed to continuous quality improvement changes under this new paradigm. The person who can best help make this strategy work the best is the critical care nurse in charge.

Coronary Care Units↗
PubMed1998

[Does an early heart attack in a parent indicate increased cardiovascular risk in the offspring?].

In a 5-year period analyzed were cardiovascular risk factors in 55 patients suffering from premature coronary accidents (below the age of 45) and in their 97 offsprings, aged 3-26 years. In 50 of these children (51.6%), 22 girls and 28 boys, in addition to the obvious positive family history, detected were other cardiovascular risk factors. The most common among them was hypercholesterolemia (in 45.0%), followed by arterial hypertension (40.0%), obesity (32.0%) and smoking (24.0%). Majority of these offsprings (64.0%) had only one additional risk factor. The average blood pressure, relative weight and cholesterol levels were significantly higher in these very children than in all the coronary offsprings (p < 0.05), and even more so (p < 0.01) than in the matching control sample.

Adolescent↗