Sunday July 22, 2018

CPR Survival Rates Lower Than Most People Think

In a scenario describing a trauma-related cardiac arrest in an 8-year-old, 71 percent predicted CPR success and 64 percent predicted long-term survival of the child

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Participants practice cardiopulmonary resuscitation (CPR) is an important life skill to know. VOA
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The majority of people believe cardiopulmonary resuscitation (CPR) is successful more often than it tends to be in reality, according to a small U.S. study.

This overly optimistic view, which may partly stem from seeing happy outcomes in television medical dramas, can get in the way of decision-making and frank conversations about end of life care with doctors, the research team writes in American Journal of Emergency Medicine.

CPR is intended to restart a heart that has stopped beating, known as cardiac arrest, which is typically caused by an electrical disturbance in the heart muscle. Although a heart attack is not the same thing — it occurs when blood flow to the heart is partly or completely blocked, often by a clot — a heart attack can also cause the heart to stop beating.

ALSO READ: 98 Percent Indians not aware of life-saving technique CPR during Heart Attack

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More often than not, cardiac arrest ends in death or severe neurological impairment. Pixabay

Odds of surviving

Whatever the cause of cardiac arrest, restarting the heart as quickly as possible to get the blood flowing to the brain is essential to prevent permanent brain damage.

The overall rate of survival that leads to hospital discharge for someone who experiences cardiac arrest is about 10.6 percent, the study authors note. But most participants in the study estimated it at more than 75 percent.

“The majority of patients and non-medical personnel have very unrealistic expectations about the success of CPR as well as the quality of life after patients are revived,” said lead author Lindsey Ouellette, a research assistant at Michigan State University’s College of Human Medicine in Grand Rapids.

Patients and family members should know about the real success rate and survival numbers when planning a living will and considering a “Do Not Resuscitate” order, Ouellette said.

“We think it is best to have the latest and most accurate information when dealing with this life-impacting decision, whether or not to undertake or continue CPR,” she told Reuters Health in an email.

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In addition to asking about general knowledge of CPR and personal experiences with CPR, the researchers presented participants with several scenarios and asked them to estimate the likelihood of CPR success and patient survival in each case. Pixabay

ALSO READ: Men with Heart Disease More Prone to Cardiac Arrest During or After Sex

Good TV, not good information

To gauge perceptions of CPR, the researchers surveyed 1,000 adults at four academic medical centers in Michigan, Illinois, and California. Participants included non-critically ill patients and families of patients, who were interviewed during random hospital shifts.

One scenario involved a 54-year-old who suffered a heart attack at home and required CPR by paramedics. About 72 percent of the survey participants predicted survival and 65 percent predicted a complete neurological recovery.

In a scenario describing a trauma-related cardiac arrest in an 8-year-old, 71 percent predicted CPR success and 64 percent predicted long-term survival of the child.

“Many people felt if a person was successfully revived, they would return to ‘normal’ rather than possibly needing lifelong care,” Ouellette said.

At the same time, more than 70 percent of respondents said they watched TV medical dramas regularly, and 12 percent said these shows were a reliable source of health information.

“Tempering unrealistic expectations may not make for ‘good TV,’ but perhaps we can get a better idea of just how these dramas may impact the views people hold about CPR and other aspects of medicine,” she said.

ALSO READ: Cardiac arrest may be fatal for those living in high rise buildings

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CPR should be part of the conversation about end-of-life care and advanced directives among families, said Carolyn Bradley of Yale-New Haven Hospital in Connecticut. Pixabay

Medical act, not miracle

“People think about CPR as a miracle, but it’s another medical act,” said Dr. Juan Ruiz-Garcia of Hospital Universitario de Torrejon in Madrid who wasn’t involved in the study. “I’m not really sure what people would choose if they knew the real prognosis of it,” he told Reuters Health by phone.

“When doing CPR at a hospital, we tend to move the family away, but we’ve created a situation where families may not be there for the final moments,” she said in a phone interview.

“Have a critical conversation with your health care provider and go with questions about what would happen during CPR,” she said. “What does it look like? What happens to my body? Who will be around? It could be the end-of-life. Statistically, it is.” (VOA)

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Know Your ‘Heart Age’ to Avert Attack

Patients who were told their Heart Age were far more likely to take action to live healthier lifestyles, such as quitting smoking

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Atrial fibrillation (Afib) disorder, is characterised by increased or irregular heart rhythm that increases the risk of stroke, heart failure and other cardiovascular diseases. Pixabay

You are more likely to adopt healthy lifestyle if you know your ‘Heart Age’ rather than just knowing the “chances” of your developing a cardiovascular disease, claims a study.

Cardiovascular disease (CVD) is the world’s biggest killer, but doctors have long struggled to explain risk factors to patients in a way that encourages them to change their behaviour — thus reducing risk.

Risk scores for diseases such as CVD are usually presented as a “percent chance” of contracting the disease within the next 10 years.

Researchers at the University of the Balearic Islands, Spain, carried out the study amongst 3,153 patients, who were randomly assigned to one of three groups before completing an annual health assessment.

One group was then presented with their chances of contracting CVD expressed as a “percentage risk”, while another received the same information expressed as their estimated “Heart Age”.

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Representational image. Pixabay

A third control group only received general guidance on healthy living. Follow-up measurements were recorded a year later during the subsequent annual health assessment.

Patients who were told their Heart Age were far more likely to take action to live healthier lifestyles, such as quitting smoking.

“We know that traditional risks scores can be confusing. We wanted to test whether using the Heart Age Calculator to talk to patients about their CVD risk would have an effect on motivating them to adopt healthier lifestyles and, in turn, reduce their risk of developing CVD,” said Pedro Tauler, the lead author of the study.

Also Read: Smokers Lack Motivation, Get Tired Easily

The results showed that patients who had been told their CVD risk (both as a percentage or Heart Age) demonstrated significant decreases in their risk scores compared to the control group, with improvements being greatest in the Heart Age group.

Quitting rate for smokers was four times greater in the Heart Age group compared to those who received the traditional percentage risk scores.

“This would suggest that the mere fact of presenting the patients with information that is easy to understand has a positive effect in engaging them to take preventive action,” said Tauler. (IANS)