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Strömsöe, Anneli
Publications (10 of 28) Show all publications
Mastersong, S., McNally, B., Cullinan, J., Vellano, K., Escutnaire, J., Fitzpatrick, D., . . . Vellinga, A. (2018). Out-of-hospital cardiac arrest survival in international airports. Resuscitation, 127, 58-62
Open this publication in new window or tab >>Out-of-hospital cardiac arrest survival in international airports
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2018 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 127, p. 58-62Article in journal (Refereed) Published
Abstract [en]

Background: The highest achievable survival rate following out-of-hospital cardiac arrest is unknown. Data from airports serving international destinations (international airports) provide the opportunity to evaluate the success of pre-hospital resuscitation in a relatively controlled but real-life environment. Methods: This retrospective cohort study included all cases of out-of-hospital cardiac arrest at international airports with resuscitation attempted between January 1st, 2013 and December 31st, 2015. Crude incidence, patient, event characteristics and survival to hospital discharge/survival to 30 days (survival) were calculated. Mixed effect logistic regression analyses were performed to identify predictors of survival. Variability in survival between airports/countries was quantified using the median odds ratio. Results: There were 800 cases identified, with an average of 40 per airport. Incidence was 0.024/100,000 passengers per year. Percentage survival for all patients was 32%, and 58% for patients with an initial shockable heart rhythm. In adjusted analyses, initial shockable heart rhythm was the strongest predictor of survival (odds ratio, 36.7; 95% confidence interval [CI], 15.5-87.0). In the bystander-witnessed subgroup, delivery of a defibrillation shock by a bystander was a strong predictor of survival (odds ratio 4.8; 95% CI, 3.0-7.8). Grouping of cases was significant at country level and survival varied between countries. Conclusions: In international airports, 32% of patients survived an out-of-hospital cardiac arrest, substantially more than in the general population. Our analysis suggested similarity between airports within countries, but differences between countries. Systematic data collection and reporting are essential to ensure international airports continually maximise activities to increase survival.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD, 2018
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:mdh:diva-39822 (URN)10.1016/j.resuscitation.2018.03.024 (DOI)000433579800021 ()29550496 (PubMedID)
Available from: 2018-06-14 Created: 2018-06-14 Last updated: 2018-06-14Bibliographically approved
Djarv, T., Axelsson, C., Herlitz, J., Strömsöe, A., Israelsson, J. & Claesson, A. (2018). Traumatic cardiac arrest in Sweden 1990-2016 - A population-based national cohort study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 26(1)
Open this publication in new window or tab >>Traumatic cardiac arrest in Sweden 1990-2016 - A population-based national cohort study
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2018 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 26, no 1Article in journal (Refereed) Published
Abstract [en]

Background: Trauma is a main cause of death among young adults worldwide. Patients experiencing a traumatic cardiac arrest (TCA) certainly have a poor prognosis but population-based studies are sparse. Primarily to describe characteristics and 30-day survival following a TCA as compared with a medical out-of-hospital cardiac arrest (medical CA). Methods: A cohort study based on data from the nationwide, prospective population-based Swedish Registry for Cardiopulmonary Resuscitation (SRCR), a medical cardiac arrest registry, between 1990 and 2016. The definition of a TCA in the SRCR is a patient who is unresponsive with apnoea where cardiopulmonary resuscitation and/or defibrillation have been initiated and in whom the Emergency Medical Services (EMS, mainly a nurse-based system) reported trauma as the aetiology. Outcome was overall 30-day survival. Descriptive statistics as well as multivariable logistic regression models were used. Results: In all, between 1990 and 2016, 1774 (2.4%) cases had a TCA and 72,547 had a medical CA. Overall 30-day survival gradually increased over the years, and was 3.7% for TCAs compared to 8.2% following a medical CA (p <0.01). Among TCAs, factors associated with a higher 30-day survival were bystander witnessed and having a shockable initial rhythm (adjusted OR 2.67, 95% C.I. 1.15-6.22 and OR 8.94 95% C.I. 4.27-18.69, respectively). Discussion: Association in registry-based studies do not imply causality but TCA had short time intervals in the chain of survival as well as high rates of bystander-CPR. Conclusion: In a medical CA registry like ours, prevalence of TCAs is low and survival is poor. Registries like ours might not capture the true incidence. However, many individuals do survive and resuscitation in TCAs should not be seen futile. 

National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-39193 (URN)10.1186/s13049-018-0500-7 (DOI)000430636600001 ()2-s2.0-85045768123 (Scopus ID)
Available from: 2018-05-11 Created: 2018-05-11 Last updated: 2018-05-11Bibliographically approved
Claesson, A., Djarv, T., Nordberg, P., Ringh, M., Hollenberg, J., Axelsson, C., . . . Strömsöe, A. (2017). Medical versus non medical etiology in out-of-hospital cardiac arrest—Changes in outcome in relation to the revised Utstein template. Resuscitation, 110, 48-55
Open this publication in new window or tab >>Medical versus non medical etiology in out-of-hospital cardiac arrest—Changes in outcome in relation to the revised Utstein template
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2017 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 110, p. 48-55Article in journal (Refereed) Published
Abstract [en]

Introduction The Utstein-style recommendations for reporting etiology and outcome in out-of-hospital cardiac arrest (OHCA) from 2004 have recently been revised. Among other etiologies a medical category is now introduced, replacing the cardiac category from Utstein template 2004. Aim The aim of this study is to describe characteristics and temporal trends from reporting OHCA etiology according to the revised Utstein template 2014 in regards to patient characteristics and 30-day survival rates. Methods This registry study is based on consecutive OHCA cases reported from the Emergency medical services (EMS) to the Swedish Registry of Cardiopulmonary Resuscitation (SRCR) 1992–2014. Characteristics, including a presumed cardiac etiology in Utstein template 2004, were transcribed to a medical etiology in Utstein template 2014. Results Of a total of n = 70,846 cases, 92% were categorized as having a medical etiology and 8% as having a non-medical cause. Using the new classifications, the 30-day survival rate has significantly increased over a 20-year period from 4.7% to 11.0% in the medical group and from 3% to 9.9% in the non-medical group (p ≤ 0.001). Trauma was the most common cause in OHCA of a non-medical etiology (26%) with a 30-day survival rate of 3.4% whilst drowning and drug overdose had the highest survival rates (14% and 10% respectively). Conclusion Based on Utstein 2014 categories of etiology, overall survival after OHCA with a medical etiology has more than doubled in a 20-year period and tripled for non-medical cases. Patients with a medical etiology found in a shockable rhythm have the highest chance of survival. There is great variability in characteristics among non-medical cases.

Keywords
CPR, EMS, Etiology, OHCA, Template, Utstein
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-34024 (URN)10.1016/j.resuscitation.2016.10.019 (DOI)000396380000016 ()27826118 (PubMedID)2-s2.0-84995687675 (Scopus ID)
Available from: 2016-12-02 Created: 2016-12-02 Last updated: 2018-10-16Bibliographically approved
Gräsner, J., Lefering, R., Koster, R., Masterson, S., Böttiger, B., Herlitz, J., . . . Bossaert, L. (2016). EuReCa ONE-27 Nations, ONE Europe, ONE Registry: A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe. Resuscitation, 105(1), 188-195
Open this publication in new window or tab >>EuReCa ONE-27 Nations, ONE Europe, ONE Registry: A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe
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2016 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 105, no 1, p. 188-195Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION:

The aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe.

METHODS:

This was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries.

RESULTS:

Data on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge.

CONCLUSION:

The results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe. EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events

National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-32622 (URN)10.1016/j.resuscitation.2016.06.004 (DOI)000381647900046 ()27321577 (PubMedID)2-s2.0-84976633569 (Scopus ID)
Available from: 2016-08-23 Created: 2016-08-23 Last updated: 2018-10-16Bibliographically approved
Graesner, J.-T., Lefering, R., Koster, R. W., Masterson, S., Boettiger, B. W., Herlitz, J., . . . Bossaert, L. L. (2016). EuReCa ONE-27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe (vol 105, pg 188, 2016). Resuscitation, 109, 145-146
Open this publication in new window or tab >>EuReCa ONE-27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe (vol 105, pg 188, 2016)
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2016 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 109, p. 145-146Article in journal (Refereed) Published
Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD, 2016
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-40308 (URN)10.1016/j.resuscitation.2016.10.001 (DOI)000389512100029 ()27750053 (PubMedID)
Available from: 2018-08-22 Created: 2018-08-22 Last updated: 2018-08-22Bibliographically approved
Hagiwara, M. A., Nilsson, L., Strömsöe, A., Axelsson, C., Kängström, A. & Herlitz, J. (2016). Patient safety and patient assessment in pre-hospital care: A study protocol. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 24(1), Article ID 14.
Open this publication in new window or tab >>Patient safety and patient assessment in pre-hospital care: A study protocol
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2016 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, Vol. 24, no 1, article id 14Article in journal (Refereed) Published
Abstract [en]

Background: Patient safety issues in pre-hospital care are poorly investigated. The aim of the planned study is to survey patient safety problems in pre-hospital care in Sweden. Methods/Design: The study is a retro-perspective structured medical record review based on the use of 11 screening criteria. Two instruments for structured medical record review are used: a trigger tool instrument designed for pre-hospital care and a newly development instrument designed to compare the pre-hospital assessment with the final hospital assessment. Three different ambulance organisations are participating in the study. Every month, one rater in each organisation randomly collects 30 medical records for review. With guidance from the review instrument, he/she independently reviews the record. Every month, the review team meet for a discussion of problematic reviews. The results will be analysed with descriptive statistics and logistic regression. Discussion: The findings will make an important contribution to knowledge about patient safety issues in pre-hospital care. © 2016 Hagiwara et al.

National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-31199 (URN)10.1186/s13049-016-0206-7 (DOI)000370594000001 ()2-s2.0-84957895037 (Scopus ID)
Available from: 2016-02-25 Created: 2016-02-25 Last updated: 2016-08-24Bibliographically approved
Strömsöe, A. (2015). Cardiopulmonary resuscitation in Sweden – yesterday, today and tomorrow. In: : . Paper presented at HLR och vatten, Svenska livräddningssällskapet, Stockholm..
Open this publication in new window or tab >>Cardiopulmonary resuscitation in Sweden – yesterday, today and tomorrow
2015 (Swedish)Conference paper, Oral presentation only (Other (popular science, discussion, etc.))
National Category
Clinical Medicine
Identifiers
urn:nbn:se:mdh:diva-32895 (URN)
Conference
HLR och vatten, Svenska livräddningssällskapet, Stockholm.
Available from: 2016-08-24 Created: 2016-08-24 Last updated: 2016-12-27Bibliographically approved
Strömsöe, A., Svensson, L., Axelsson, Å. B., Claesson, A., Göransson, K. E., Nordberg, P. & Herlitz, J. (2015). Improved outcome in Sweden after out-of-hospital cardiac arrest and possible association with improvements in every link in the chain of survival. European Heart Journal, 36(14), 863-871
Open this publication in new window or tab >>Improved outcome in Sweden after out-of-hospital cardiac arrest and possible association with improvements in every link in the chain of survival
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2015 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 36, no 14, p. 863-871Article in journal (Refereed) Published
Abstract [en]

Aims: To describe out-of-hospital cardiac arrest (OHCA) in Sweden from a long-term perspective in terms of changes in outcome and circumstances at resuscitation.

Methods and results: All cases of OHCA (n = 59 926) reported to the Swedish Cardiac Arrest Register from 1992 to 2011 were included. The number of cases reported (n/100 000 person-years) increased from 27 (1992) to 52 (2011). Crew-witnessed cases, cardiopulmonary resuscitation prior to the arrival of the emergency medical service (EMS), and EMS response time increased (P < 0.0001). There was a decrease in the delay from collapse to calling for the EMS in all patients and from collapse to defibrillation among patients found in ventricular fibrillation (P< 0.0001). The proportion of patients found in ventricular fibrillation decreased from 35 to 25% (P < 0.0001). Thirty-day survival increased from 4.8 (1992) to 10.7% (2011) (P < 0.0001), particularly among patients found in a shockable rhythm and patients with return of spontaneous circulation (ROSC) at hospital admission. Among patients hospitalized with ROSC in 2008–2011, 41% underwent therapeutic hypothermia and 28% underwent percutaneous coronary intervention. Among 30-day survivors in 2008–2011, 94% had a cerebral performance category score of 1 or 2 at discharge from hospital and the results were even better if patients were found in a shockable rhythm.

Conclusion: From a long-term perspective, 30-day survival after OHCA in Sweden more than doubled. The increase in survival was most marked among patients found in a shockable rhythm and those hospitalized with ROSC. There were improvements in all four links in the chain of survival, which might explain the improved outcome.

Place, publisher, year, edition, pages
Oxford University Press, 2015
Keywords
Cardiopulmonary resuscitation, Registries, Survival
National Category
Clinical Medicine
Identifiers
urn:nbn:se:mdh:diva-32764 (URN)10.1093/eurheartj/ehu240 (DOI)000353541400009 ()2-s2.0-84928389123 (Scopus ID)
Available from: 2014-06-26 Created: 2016-08-24 Last updated: 2017-11-28Bibliographically approved
Gelberg, J., Strömsöe, A., Hollenberg, J., Radell, P., Claesson, A., Svensson, L. & Herlitz, J. (2015). Improving survival and neurologic function for younger age groups after out-of-hospital cardiac arrest in Sweden: a 20-year comparison. Pediatric Critical Care Medicine, 16(8), 750-757
Open this publication in new window or tab >>Improving survival and neurologic function for younger age groups after out-of-hospital cardiac arrest in Sweden: a 20-year comparison
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2015 (English)In: Pediatric Critical Care Medicine, ISSN 1529-7535, E-ISSN 1947-3893, Vol. 16, no 8, p. 750-757Article in journal (Refereed) Published
Abstract [en]

Objective: To describe changes in the epidemiology of out-of-hospital cardiac arrest in Sweden with the emphasis on the younger age groups.

Design: Prospective observational study. Setting: Sweden.

Patients: Patients were recruited from the Swedish Registry of Cardiopulmonary Resuscitation from 1990 to 2012. Only non-crew-witnessed cases were included.

Intervention: Cardiopulmonary resuscitation.

Measurement and Main Results: The endpoint was 30-day survival. Cerebral function among survivors was estimated according to the cerebral performance category scores. In all, 50,879 patients in the survey had an out-of-hospital cardiac arrest, of which 1,321 (2.6%) were 21 years old or younger and 1,543 (3.0%) were 22-35 years old. On the basis of results from 2011 and 2012, we estimated that there are 4.9 cases per 100,000 person-years in the age group 0-21 years. The highest survival was found in the 13- to 21-year age group (12.6%). Among patients 21 years old or younger, the following were associated with an increased chance of survival: increasing age, male gender, witnessed out-of-hospital cardiac arrest, ventricular-fibrillation, and a short emergency medical service response time. Among patients 21 years old or younger, there was an increase in survival from 6.2% in 1992-1998 to 14.0% in 2007-2012. Among 30-day survivors, 91% had a cerebral performance category score of 1 or 2 (good cerebral performance or moderate cerebral disability) at hospital discharge.

Conclusions: In Sweden, among patients 21 years old or younger, five out-of-hospital cardiac arrests per 100,000 person-years occur and survival in this patient group has more than doubled during the past two decades. The majority of survivors have good or relatively good cerebral function.

Keywords
children, out-of-hospital cardiac arrest, outcome
National Category
Clinical Medicine
Research subject
Health and Welfare
Identifiers
urn:nbn:se:mdh:diva-32751 (URN)10.1097/PCC.0000000000000503 (DOI)000369708000016 ()26218255 (PubMedID)
Available from: 2016-03-04 Created: 2016-08-24 Last updated: 2017-11-28Bibliographically approved
Strömsöe, A. (2015). Kvalitetsindikatorer i det svenska hjärt-lungräddningsregistret. In: : . Paper presented at Skandinavisk akutmedicin 2015, Trondheim, Norge.
Open this publication in new window or tab >>Kvalitetsindikatorer i det svenska hjärt-lungräddningsregistret
2015 (Swedish)Conference paper, Oral presentation only (Other academic)
National Category
Clinical Medicine
Identifiers
urn:nbn:se:mdh:diva-32896 (URN)
Conference
Skandinavisk akutmedicin 2015, Trondheim, Norge
Available from: 2016-08-24 Created: 2016-08-24 Last updated: 2016-12-19Bibliographically approved
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