Pulseless electrical activity epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Karol Gema Hernandez, M.D. [2]
Overview
It is well known that there are several epidemiologic and demographic factors than influence in the incidence of PEA, like black race and sex, being females more susceptible. There has been also changes in incidence of PEA over the last three decades.
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. There were also other authors suggesting racial differences between survival. [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.