Document Detail


Outcome of cardiac arrests attended by emergency medical services staff at community outpatient dialysis centers.
MedLine Citation:
PMID:  18172435     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiac arrest is the leading cause of death among dialysis patients in the United States. We measured the outcome of cardiac arrests attended by Emergency Medical Services (EMS) staff at hemodialysis facilities in a 14-year population-based retrospective study to identify cardiac arrest cases at a dialysis unit. Associated factors were determined using unconditional logistic regression. Of the 102 cardiac arrests identified around the time of dialysis, 10 occurred before, 72 during, and 20 after hemodialysis. The initial measured abnormality was ventricular fibrillation or tachycardia in 72 cases. Of those who survived transportation to a hospital, survival to discharge was 24 with 15% survival at 1 year. Compared to arrests that occurred prior to dialysis, the odds of ventricular fibrillation were 5-fold greater in patients on dialysis but 14-fold greater in those arresting after dialysis. One-third of cases occurred after the introduction of automated external defibrillators, and in half of the cases these devices were attached prior to EMS arrival. Once these devices were attached, most were used for defibrillation. We conclude that ventricular arrhythmias are the predominant features among arrested in-center dialysis patients with most occurrences during dialysis. The role of these devices in dialysis units will need a larger study to evaluate their efficacy.
Authors:
T R Davis; B A Young; M S Eisenberg; T D Rea; M K Copass; L A Cobb
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-01-02
Journal Detail:
Title:  Kidney international     Volume:  73     ISSN:  1523-1755     ISO Abbreviation:  Kidney Int.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-01     Completed Date:  2008-06-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  933-9     Citation Subset:  IM    
Affiliation:
School of Medicine, University of Washington, Seattle, Washington, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Community Health Centers / statistics & numerical data
Defibrillators
Emergency Medical Services* / statistics & numerical data
Female
Heart Arrest / epidemiology,  etiology,  therapy*
Humans
Incidence
Kidney Failure, Chronic / complications*,  therapy
Male
Middle Aged
Renal Dialysis
Retrospective Studies
Treatment Outcome
Washington / epidemiology
Comments/Corrections
Comment In:
Kidney Int. 2008 Apr;73(8):907-8   [PMID:  18379526 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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