Unmatched patients who underwent extracorporeal CPR had a higher survival rate to discharge (log-rank p<0 . 0001) and a better 1-year survival than those who received conventional CPR (log rank p=0.007). Between the propensity-score matched groups, there was still a significant difference PLX4032 in survival to discharge (hazard ratio [HR] 0. 51, 95% CI 0.35-0.74, p<0.0001), 30-day survival (HR 0 .47, 95% CI
0 . 28-0.77, p=0.003), and 1-year survival (HR 0.53, 95% Cl 0.33-0.83, p=0.006) favouring extracorporeal CPR over conventional CPR.
Interpretation Extracorporeal CPR had a short-term and long-term survival benefit over conventional CPR in patients with in-hospital cardiac arrest of cardiac origin.
Funding National Science Council, Taiwan.”
“Background Although epidural anaesthesia and analgesia have numerous benefits, their effects on postoperative survival are unclear. We therefore undertook a population-based cohort study to determine whether perioperative epidural anaesthesia or analgesia is associated with improved 30-day survival.
Methods We used selleck products population-based linked administrative 6latabases to do a retrospective cohort study of 259037 patients, aged 40 years or older, who underwent selected elective intermediate-to-high risk non-cardiac surgical procedures between April 1, 1994, and March 31, 2004, in Ontario,
Canada. Propensity-score methods were used to construct a matched-pairs cohort that reduced important baseline differences between patients who received epidural anaesthesia or analgesia as opposed to those that did not. We then 4-Aminobutyrate aminotransferase determined the association of epidural anaesthesia with 30-day mortality within these matched-pairs.
Findings
Of the 259037 patients, 56556 (22%) received epidural anaesthesia. Within the matched-pairs cohort (n=88 188), epidural anaesthesia was associated with a small reduction in 30-day mortality (1 . 7% vs 2. 0%; relative risk 0 . 89, 95% Cl 0 . 81-0. 98, p=0. 02).
Interpretation Epidural anaesthesia and analgesia were associated with a small improvement in 30-day survival, but this effect should be interpreted cautiously. The estimate had borderline significance, despite a large sample size. Its absolute magnitude was also small, corresponding to a number needed to treat of 477. Our study, therefore, does not provide compelling evidence that epidural anaesthesia improves postoperative survival. Nonetheless, our results support the safety of perioperative epidural anaesthesia when used for indications other than improving survival (eg, improving postoperative pain relief, preventing postoperative pulmonary complications).
Funding Institute for Clinical Evaluative Sciences.”
“Modern management of acute myocardial infarction is built on a clinical evidence base drawn from many studies undertaken over the past three decades.
No related posts.