| Accuracy and impact of presumed cause in patients with cardiac arrest. | |
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MedLine Citation:
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PMID: 9727546 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: International guidelines recommend differentiation between cardiac and noncardiac causes of cardiac arrest. The aim of this study was to find the rate of agreement between primarily postulated and definitive causes of cardiac arrest. METHODS AND RESULTS: We retrospectively analyzed the primarily presumed cause of cardiac arrest as determined by the emergency room physician on admission in all patients admitted to the emergency department of one urban tertiary care hospital. This was compared with the definitive cause as established by clinical evidence or autopsy. Within 4 years, the initially presumed cause was unclear in 24 (4%) of 593 patients. In the remaining 569 patients, the presumed cause was correct in 509 (89%) and wrong in 60 (11%) cases. Cardiac origin was presumed in 421 (71%) and the definitive cause in 408 (69%) cases. Noncardiac origin was presumed in 148 (25%) and the definitive cause in 185 (31%) patients. Presumed cardiac cause was sensitive (96%) but less specific (77%). Noncardiac causes such as pulmonary embolism, cerebral disorders, or exsanguination were those most frequently overlooked. Asystole occurred significantly more often in patients in whom presumed cause remained undetermined or differed from the definitive cause. CONCLUSIONS: Cause of cardiac arrest is not as easily recognized as anticipated, especially when the initial rhythm is different from ventricular fibrillation. This might affect comparability of study results, therapeutic strategies, prognosis, and outcome. Patients in whom the presumed cause was confirmed as being correct had significantly better survival and neurological outcome. |
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Authors:
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I Kürkciyan; G Meron; W Behringer; F Sterz; A Berzlanovich; H Domanovits; M Müllner; H C Bankl; A N Laggner |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 98 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1998 Aug |
Date Detail:
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Created Date: 1998-09-17 Completed Date: 1998-09-17 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 766-71 Citation Subset: AIM; IM |
Affiliation:
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Department of Emergency Medicine, General Hospital of Vienna, University of Vienna, Austria. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Diagnosis, Differential Diagnostic Errors Emergency Service, Hospital Female Heart Arrest / etiology* Humans Male Middle Aged Reproducibility of Results Retrospective Studies Risk Factors Sensitivity and Specificity |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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