Resuscitation · 2003
Opportunities to prevent sudden out-of-hospital death due to coronary heart disease in a community.
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Wu Lambert A, Kottke Thomas E, Brekke Lee N, Brekke Mark J, Grill Diane E, Goraya Tauqir Y, Roger Veronique L, Belau Paul G, White Roger D
Аннотация
BACKGROUND: Intervening successfully to reduce the burden of sudden out-of-hospital death due to coronary heart disease (OHCD) requires knowledge of where these deaths occur and whether they are observed by bystanders.
METHODS: To establish the proportion of OHCDs that were witnessed and where they occurred, we reviewed the coroner's notes and medical records of a previously-described sample of OHCD cases among residents of Olmsted County, Minnesota. This cohort (n=113) consisted of a 10% random sample of all Olmsted County residents who died out-of-hospital between 1981 and 1994 and whose deaths were attributed to coronary heart disease.
RESULTS: Excluding deaths in nursing homes (n=27), 71 (83%) of the deaths occurred in private homes and 15 (17%) occurred in public places. The event was not witnessed in 59% of deaths occurring in private homes and in 20% of deaths occurring in public places. The presence or absence of a bystander could not be established for 10% of deaths in private homes and 7% of deaths in public areas.
CONCLUSIONS: A significant proportion of OHCDs occur in private homes and are not witnessed. Prevention of unwitnessed deaths will require programs that result in primary prevention and/or calls to first responders at the time of impending cardiac arrest.
METHODS: To establish the proportion of OHCDs that were witnessed and where they occurred, we reviewed the coroner's notes and medical records of a previously-described sample of OHCD cases among residents of Olmsted County, Minnesota. This cohort (n=113) consisted of a 10% random sample of all Olmsted County residents who died out-of-hospital between 1981 and 1994 and whose deaths were attributed to coronary heart disease.
RESULTS: Excluding deaths in nursing homes (n=27), 71 (83%) of the deaths occurred in private homes and 15 (17%) occurred in public places. The event was not witnessed in 59% of deaths occurring in private homes and in 20% of deaths occurring in public places. The presence or absence of a bystander could not be established for 10% of deaths in private homes and 7% of deaths in public areas.
CONCLUSIONS: A significant proportion of OHCDs occur in private homes and are not witnessed. Prevention of unwitnessed deaths will require programs that result in primary prevention and/or calls to first responders at the time of impending cardiac arrest.