Pulseless electrical activity epidemiology and demographics: Difference between revisions
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==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
PEA accounts for approximately 20% of out of hospital cardiac arrests, and accounts for about a third of inhospital cardiac arrests. <ref name="pmid16391216">{{cite journal | author = Nadkarni VM, Larkin GL, Peberdy MA, Carey SM, Kaye W, Mancini ME, Nichol G, Lane-Truitt T, Potts J, Ornato JP, Berg RA | title = First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults | journal = JAMA : the Journal of the American Medical Association | volume = 295 | issue = 1 | pages = 50–7 | year = 2006 | month = January | pmid = 16391216 | doi = 10.1001/jama.295.1.50 | url = http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.295.1.50 | issn = | accessdate = 2012-09-16}}</ref> PEA is responsible for 10% of in-hospital deaths.<ref name="pmid831417">{{cite journal | author = Raizes G, Wagner GS, Hackel DB | title = Instantaneous nonarrhythmic cardiac death in acute myocardial infarction | journal = The American Journal of Cardiology | volume = 39 | issue = 1 | pages = 1–6 | year = 1977 | month = January | pmid = 831417 | doi = | url = http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(77)80002-7 | issn = | accessdate = 2012-09-16}}</ref> | PEA accounts for approximately 20% of out of hospital cardiac arrests, and accounts for about a third of inhospital cardiac arrests. <ref name="pmid16391216">{{cite journal | author = Nadkarni VM, Larkin GL, Peberdy MA, Carey SM, Kaye W, Mancini ME, Nichol G, Lane-Truitt T, Potts J, Ornato JP, Berg RA | title = First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults | journal = JAMA : the Journal of the American Medical Association | volume = 295 | issue = 1 | pages = 50–7 | year = 2006 | month = January | pmid = 16391216 | doi = 10.1001/jama.295.1.50 | url = http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.295.1.50 | issn = | accessdate = 2012-09-16}}</ref> PEA is responsible for 10% of in-hospital deaths.<ref name="pmid831417">{{cite journal | author = Raizes G, Wagner GS, Hackel DB | title = Instantaneous nonarrhythmic cardiac death in acute myocardial infarction | journal = The American Journal of Cardiology | volume = 39 | issue = 1 | pages = 1–6 | year = 1977 | month = January | pmid = 831417 | doi = | url = http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(77)80002-7 | issn = | accessdate = 2012-09-16}}</ref> | ||
According to Myerburg et al <ref name="pmid24297818">{{cite journal| author=Myerburg RJ, Halperin H, Egan DA, Boineau R, Chugh SS, Gillis AM et al.| title=Pulseless electric activity: definition, causes, mechanisms, management, and research priorities for the next decade: report from a national heart, lung, and blood institute workshop. | journal=Circulation | year= 2013 | volume= 128 | issue= 23 | pages= 2532-41 | pmid=24297818 | doi=10.1161/CIRCULATIONAHA.113.004490 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24297818 }} </ref> SCA incidence is approximately of 300,000 to 370,000 cases per year, and represents 50% of the causes of cardiovascular mortality. Half of the cases of SCA are the first clinical manifestation of an undiagnosed cardiac disease. Also, half of the cases of SCA are due to PEA. | |||
===Age=== | ===Age=== | ||
Patients with PEA tend to be older. | Patients with PEA tend to be older. | ||
===Gender=== | ===Gender=== | ||
There is a slight female preponderance of PEA. It is unclear if this is mediated by a direct influence of gender on the pathophysiology, or if female gender is a confounder. | There is a slight female preponderance of PEA. It is unclear if this is mediated by a direct influence of gender on the pathophysiology, or if female gender is a confounder. | ||
===Race=== | |||
Teodorescu et al suggest that black race is strongly correlated with the presentation of PEA <ref name="pmid8341333">{{cite journal| author=Becker LB, Han BH, Meyer PM, Wright FA, Rhodes KV, Smith DW et al.| title=Racial differences in the incidence of cardiac arrest and subsequent survival. The CPR Chicago Project. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 9 | pages= 600-6 | pmid=8341333 | doi=10.1056/NEJM199308263290902 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8341333 }} </ref> <ref name="pmid9546017">{{cite journal| author=Chu K, Swor R, Jackson R, Domeier R, Sadler E, Basse E et al.| title=Race and survival after out-of-hospital cardiac arrest in a suburban community. | journal=Ann Emerg Med | year= 1998 | volume= 31 | issue= 4 | pages= 478-82 | pmid=9546017 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9546017 }} </ref> | |||
===Epidemiological Patterns== | |||
As demonstrated by the workshop made by Myerburg et al <ref name="pmid24297818">{{cite journal| author=Myerburg RJ, Halperin H, Egan DA, Boineau R, Chugh SS, Gillis AM et al.| title=Pulseless electric activity: definition, causes, mechanisms, management, and research priorities for the next decade: report from a national heart, lung, and blood institute workshop. | journal=Circulation | year= 2013 | volume= 128 | issue= 23 | pages= 2532-41 | pmid=24297818 | doi=10.1161/CIRCULATIONAHA.113.004490 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24297818 }} </ref>, there has been a decrease of VT/VF as the cause of sudden cardiac arrest, from 70% to 20%- 25%. There was a decrease of 20% of the incidence of VT/VF from 1979-1980 to 1999-2000, supported by observations made by he Seattle study in 2002. In this same study, PEA incidence showed an increase in prevalence of 11%. Teodorescu et all suggest that one of the causes for the decrease in VF/VT prevalence are due to the strategies against CAD and hyperlipidemia that were taken <ref name="pmid21060069">{{cite journal| author=Teodorescu C, Reinier K, Dervan C, Uy-Evanado A, Samara M, Mariani R et al.| title=Factors associated with pulseless electric activity versus ventricular fibrillation: the Oregon sudden unexpected death study. | journal=Circulation | year= 2010 | volume= 122 | issue= 21 | pages= 2116-22 | pmid=21060069 | doi=10.1161/CIRCULATIONAHA.110.966333 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21060069 }} </ref>. Therefore, they hypothesize that the increased incidence of PEA can be explained by a high prevalence of comorbidities or extra cardiac conditions in these patients. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Epidemiology and Demographics
PEA accounts for approximately 20% of out of hospital cardiac arrests, and accounts for about a third of inhospital cardiac arrests. [1] PEA is responsible for 10% of in-hospital deaths.[2] According to Myerburg et al [3] SCA incidence is approximately of 300,000 to 370,000 cases per year, and represents 50% of the causes of cardiovascular mortality. Half of the cases of SCA are the first clinical manifestation of an undiagnosed cardiac disease. Also, half of the cases of SCA are due to PEA.
Age
Patients with PEA tend to be older.
Gender
There is a slight female preponderance of PEA. It is unclear if this is mediated by a direct influence of gender on the pathophysiology, or if female gender is a confounder.
Race
Teodorescu et al suggest that black race is strongly correlated with the presentation of PEA [4] [5]
=Epidemiological Patterns
As demonstrated by the workshop made by Myerburg et al [3], there has been a decrease of VT/VF as the cause of sudden cardiac arrest, from 70% to 20%- 25%. There was a decrease of 20% of the incidence of VT/VF from 1979-1980 to 1999-2000, supported by observations made by he Seattle study in 2002. In this same study, PEA incidence showed an increase in prevalence of 11%. Teodorescu et all suggest that one of the causes for the decrease in VF/VT prevalence are due to the strategies against CAD and hyperlipidemia that were taken [6]. Therefore, they hypothesize that the increased incidence of PEA can be explained by a high prevalence of comorbidities or extra cardiac conditions in these patients.
References
- ↑ Nadkarni VM, Larkin GL, Peberdy MA, Carey SM, Kaye W, Mancini ME, Nichol G, Lane-Truitt T, Potts J, Ornato JP, Berg RA (2006). "First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults". JAMA : the Journal of the American Medical Association. 295 (1): 50–7. doi:10.1001/jama.295.1.50. PMID 16391216. Retrieved 2012-09-16. Unknown parameter
|month=ignored (help) - ↑ Raizes G, Wagner GS, Hackel DB (1977). "Instantaneous nonarrhythmic cardiac death in acute myocardial infarction". The American Journal of Cardiology. 39 (1): 1–6. PMID 831417. Retrieved 2012-09-16. Unknown parameter
|month=ignored (help) - ↑ 3.0 3.1 Myerburg RJ, Halperin H, Egan DA, Boineau R, Chugh SS, Gillis AM; et al. (2013). "Pulseless electric activity: definition, causes, mechanisms, management, and research priorities for the next decade: report from a national heart, lung, and blood institute workshop". Circulation. 128 (23): 2532–41. doi:10.1161/CIRCULATIONAHA.113.004490. PMID 24297818.
- ↑ Becker LB, Han BH, Meyer PM, Wright FA, Rhodes KV, Smith DW; et al. (1993). "Racial differences in the incidence of cardiac arrest and subsequent survival. The CPR Chicago Project". N Engl J Med. 329 (9): 600–6. doi:10.1056/NEJM199308263290902. PMID 8341333.
- ↑ Chu K, Swor R, Jackson R, Domeier R, Sadler E, Basse E; et al. (1998). "Race and survival after out-of-hospital cardiac arrest in a suburban community". Ann Emerg Med. 31 (4): 478–82. PMID 9546017.
- ↑ Teodorescu C, Reinier K, Dervan C, Uy-Evanado A, Samara M, Mariani R; et al. (2010). "Factors associated with pulseless electric activity versus ventricular fibrillation: the Oregon sudden unexpected death study". Circulation. 122 (21): 2116–22. doi:10.1161/CIRCULATIONAHA.110.966333. PMID 21060069.