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Orlob S, Grundner S, Wittig J, Eichinger M, Pucher F, Eichlseder M, Lingitz R, Rief M, Palt N, Hartwig C, Zangl G, Haar M, Manninger M, Rohrer U, Scherr D, Zirlik A, Prause G, Zweiker D. Assessing the weak links - Necessity and impact of regional cardiac arrest awareness campaigns for laypersons. Resusc Plus 2023; 13:100352. [PMID: 36654724 PMCID: PMC9841163 DOI: 10.1016/j.resplu.2022.100352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Introduction Public knowledge of out-of-hospital cardiac arrest (OHCA), and initiation of basic life support (BLS) is crucial to increase survival in OHCA. Methods The study analysed the knowledge and willingness to perform BLS of laypersons passing an AED at a public train station. Interviewees were recruited at two time points before and after a four year-long structured regional awareness campaign, which focused on call, compress, shock in a mid-size European city (270,000 inhabitants). Complete BLS was defined as multiple responses for call for help; initiation of chest compressions; and usage of an AED, without mentioning recovery position. Minimal BLS was defined as call for help and initiation of chest compressions. Results A total of 784 persons were interviewed, 257 at baseline and 527 post-campaign. Confronted with a fictional OHCA, at baseline 8.5% of the interviewees spontaneously mentioned actions for complete BLS and 17.9% post-campaign (p = 0.009). An even larger increase in knowledge was seen in minimal BLS (34.6% vs 60.6%, p < 0.001). Conclusion After a regional cardiac arrest awareness campaign, we found an increase in knowledge of BLS actions in the lay public. However, our investigation revealed severe gaps in BLS knowledge, possibly resulting in weak first links of the chain of survival.
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Affiliation(s)
- Simon Orlob
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Stephan Grundner
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria,Department of Diagnostic and Interventional Radiology, Ordensklinikum Linz Elisabethinen, Fadingerstraße 1, 4020 Linz, Austria
| | - Johannes Wittig
- Research Center for Emergency Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 161, 8200 Aarhus N, Denmark,Medical University of Graz; Auenbruggerplatz 12, 8036 Graz, Austria
| | - Michael Eichinger
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Felix Pucher
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Michael Eichlseder
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Raphaela Lingitz
- Department of Paediatrics, Hospital Wiener Neustadt, Corvinusring 3-5, 2700 Wiener Neustadt, Austria
| | - Martin Rief
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Niklas Palt
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria,Medical University of Graz; Auenbruggerplatz 12, 8036 Graz, Austria
| | - Charlotte Hartwig
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Gregor Zangl
- State Hospital Hochsteiermark, Location Bruck, Tragösser Strasse 1, 8600 Bruck an der Mur, Austria
| | - Markus Haar
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246 Hamburg, Germany
| | - Martin Manninger
- Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria,Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands
| | - Ursula Rohrer
- Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Daniel Scherr
- Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Andreas Zirlik
- Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Gerhard Prause
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - David Zweiker
- Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria,Third Medical Department for Cardiology and Intensive Care, Clinic Ottakring, Montleartstraße 37, Pavillon 29, 1160 Vienna, Austria,Corresponding author at: Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
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G Toth G, Lansky A, Baumbach A, Kelbæk H, van Royen N, Holmvang L, Janssens L, Brugaletta S, Barbato E, Maillard L, Kiemeneij F, Naber CK, Pucher F, Laursen PN, Ameloot K, Robles C, Milkas A, Sevilla J, Jensen C, Wijns W. Validation of the all-comers design: Results of the TARGET-AC substudy. Am Heart J 2020; 221:148-154. [PMID: 31924299 DOI: 10.1016/j.ahj.2019.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/30/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Results of clinical trials are often criticized by low inclusion rate and potential sampling bias in patient recruitment. The aim of this validation registry is to evaluate how far an all-comers design in the context of clinical research can ensure the representation of the true all-comers population. METHODS This validation registry is a prospective international multicentre registry, conducted at 10 out of the total 21 centers, participating in TARGET-AC (registered under NCT02520180). During a predefined four-week period data were recorded prospectively on all PCIs performed in the participating centers, whether or not patients were enrolled in TARGET-AC. Data were collected on patient demographics, angiographic lesion- and procedural characteristics. For patients who were not enrolled in the study, operators were asked to declare the reason for not enrolling the patient, using a single-choice questionnaire. RESULTS A total of 131 patients were enrolled in the TARGET-AC study during the investigated period (ER group), standing as 20% (range 4% and 54%) of all eligible cases per protocol. In the ER group more patients presented with stable angina (61% vs. 43%, respectively; P < .001). Whereas ST-elevation infarction was less common (5% vs. 26%, respectively; P < .001), there was no difference in non-ST elevation acute coronary syndrome (32% vs. 27%, respectively; P = .248). Risk factors and comorbidities did not show any difference between the ER and the non-enrolled (NER) groups, except for greater rate of significant valvular disease in the NER group (12% vs 19%, respectively; P = .037). The NER group presented more thrombotic stenoses than the ER group (20% vs 12%, respectively; P = .040). No difference was found in any other investigated angiographic parameters, like target vessels, bifurcation lesion, severe calcification or chronic total occlusions. Admission during regular working hours and availability of study nurse were associated with markedly higher recruitment rate. CONCLUSION Results suggest that TARGET AC was outbalanced for stable patients over primary PCIs as compared to real world. However in terms of risk factors and comorbidities the trial managed to represent the collective of real world clinical practice. Fairly representative cases were included at an average inclusion-to-eligible rate of 20%.
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Affiliation(s)
- Gabor G Toth
- Department of Cardiology, University Heart Center Graz, Medical University of Graz, Austria
| | - Alexandra Lansky
- Yale University School of Medicine, New Haven, CT, USA; Barts Heart Center, London and Queen Mary University of London, London, UK
| | - Andreas Baumbach
- Yale University School of Medicine, New Haven, CT, USA; Barts Heart Center, London and Queen Mary University of London, London, UK
| | - Henning Kelbæk
- Department of Cardiology, Roskilde University Hospital, Roskilde, Denmark
| | - Niels van Royen
- Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Lene Holmvang
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Luc Janssens
- Heart Center, Imelda Ziekenhuis, Bonheiden, Belgium
| | | | - Emanuele Barbato
- Cardiovascular Research Center Aalst, OLV Hospital, Aalst, Belgium; Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Luc Maillard
- Department of Cardiology, GCS ES Axium Rambot, France
| | | | | | - Felix Pucher
- Department of Cardiology, University Heart Center Graz, Medical University of Graz, Austria
| | - Peter Nørkjær Laursen
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Koen Ameloot
- Heart Center, Imelda Ziekenhuis, Bonheiden, Belgium
| | - Carlos Robles
- Cardiovascular Institute, Hospital Clinic, Barcelona, Spain
| | | | - Jose Sevilla
- Department of Cardiology, GCS ES Axium Rambot, France
| | - Christoph Jensen
- Contilia Heart and Vascular Centre, Elisabeth-Krankenhaus, Essen, Germany
| | - William Wijns
- The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway and Saolta University Healthcare Group, Ireland.
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