Fatality outside hospital from acute coronary events in three British health districts, 1994-5. United Kingdom Heart Attack Study Collaborative Group.

Abstract:

OBJECTIVES:To provide a contemporary account of the treatment and outcomes of acute coronary attacks in England and Wales and to identify strategies that might improve the outcome. DESIGN:Two year community and hospital based study in three British health districts. SETTING:Health districts of Brighton (population 282,000), South Glamorgan (408,000), and York (264,000). SUBJECTS:3523 men and women under 75 years of age who died outside hospital from acute coronary causes, who were admitted to hospital with acute myocardial infarction, or who developed acute infarction or died unexpectedly from acute coronary causes while they were already in hospital. INTERVENTIONS:Attempted resuscitation in people having a cardiac arrest outside hospital. MAIN OUTCOME MEASURES:Total case fatality, case fatality outside and inside hospital, and the effect of resuscitation on case fatality outside hospital. RESULTS:1589 patients died within 30 days of the acute event. Case fatality was 45% (95% confidence interval 43% to 47%), rising from 27% (160/595) (23% to 31%) at age < 55 years to 53% (1019/1916) (51% to 55%) at 65-74 years. Overall, 74% (1172/1589) (72% to 76%) of fatal events happened outside hospital, and there was a negative age gradient (P < 0.001) such that 91% (145/160) (87% to 95%) of fatalities occurred outside hospital at age < 55 compared with 70% (710/1019) (67% to 73%) at 65-74 years. Without successful resuscitation of 55 patients outside hospital, total case fatality at 30 days would have risen from 45% to 46.7%. CONCLUSION:Opportunities for reducing fatality from acute coronary attacks lie mainly outside hospital. These results and others imply that survival from cardiac arrest outside hospital might be trebled by improved ambulance and patient response. Proper application of secondary preventive measures for patients with coronary disease could have an even larger impact.

journal_name

BMJ

authors

Norris RM

subject

Has Abstract

pub_date

1998-04-04 00:00:00

pages

1065-70

issue

7137

eissn

0959-8138

issn

1756-1833

journal_volume

316

pub_type

杂志文章,多中心研究
  • Antibiotic prescribing without documented indication in ambulatory care clinics: national cross sectional study.

    abstract:OBJECTIVES:To identify the frequency with which antibiotics are prescribed in the absence of a documented indication in the ambulatory care setting, to quantify the potential effect on assessments of appropriateness of antibiotics, and to understand patient, provider, and visit level characteristics associated with ant...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.l6461

    authors: Ray MJ,Tallman GB,Bearden DT,Elman MR,McGregor JC

    更新日期:2019-12-11 00:00:00

  • Management of chronic hepatitis B infection.

    abstract::Hepatitis B virus (HBV) is a global health problem that can lead to cirrhosis and hepatocellular carcinoma (HCC). Although HBV vaccination has reduced the prevalence Of HBV infection, the burden of disease remains high. Treatment with antiviral drugs reduces the risk of liver disease and the development of HCC, and it...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.h4263

    authors: Sundaram V,Kowdley K

    更新日期:2015-10-21 00:00:00

  • Coffee consumption and death from coronary heart disease in middle aged Norwegian men and women.

    abstract:OBJECTIVE:To study the association between number of cups of coffee consumed per day and coronary death when taking other major coronary risk factors into account. DESIGN:Men and women attending screening and followed up for a mean of 6.4 years. SETTING:Cardiovascular survey performed by ambulatory teams from the Nat...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.300.6724.566

    authors: Tverdal A,Stensvold I,Solvoll K,Foss OP,Lund-Larsen P,Bjartveit K

    更新日期:1990-03-03 00:00:00

  • Understanding help seeking behaviour among male offenders: qualitative interview study.

    abstract:OBJECTIVE:To explore the factors that influence help seeking for mental distress by offenders. DESIGN:Qualitative study based on in-depth interviews with prisoners before and after release. SETTING:One category B local prison in southern England. PARTICIPANTS:35 male offenders aged 18-52, a quarter of whom had been ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.39059.594444.AE

    authors: Howerton A,Byng R,Campbell J,Hess D,Owens C,Aitken P

    更新日期:2007-02-10 00:00:00

  • Size at birth, maternal nutritional status in pregnancy, and blood pressure at age 17: population based analysis.

    abstract:OBJECTIVE:To assess the effect of size at birth, maternal nutrition, and body mass index on blood pressure in late adolescence. DESIGN:Population based analysis of birth weight corrected for gestational age, mother's weight before pregnancy and weight gain in pregnancy, obtained from the Jerusalem perinatal study, and...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.315.7106.449

    authors: Laor A,Stevenson DK,Shemer J,Gale R,Seidman DS

    更新日期:1997-08-23 00:00:00

  • Combined resynchronisation and implantable defibrillator therapy in left ventricular dysfunction: Bayesian network meta-analysis of randomised controlled trials.

    abstract:OBJECTIVE:To review the evidence base from randomised controlled trials of combined cardiac resynchronisation therapy and implantable cardioverter defibrillator therapy in left ventricular impairment and symptomatic heart failure. DESIGN:Bayesian network meta-analysis. DATA SOURCES:Medline, Embase, and Cochrane datab...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.39343.511389.BE

    authors: Lam SK,Owen A

    更新日期:2007-11-03 00:00:00

  • Children on hunger strike: child abuse or legitimate protest?

    abstract::The issue of children on hunger strike (voluntary total fasting) has not been reported before. The World Medical Association Declaration of Tokyo 1975 and the Declaration of Malta 1991 (revised 1992) provide clinicians with guidelines for the management of adult patients on hunger strike but do not mention children. W...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.312.7029.501

    authors: Mok A,Nelson EA,Murphy J,Hampson A,Hendriks JH

    更新日期:1996-02-24 00:00:00

  • Contribution of specific diseases and injuries to changes in health adjusted life expectancy in 187 countries from 1990 to 2013: retrospective observational study.

    abstract:OBJECTIVE:To quantify and compare the contribution of 306 diseases and injuries to the changes in health adjusted life expectancy at birth (HALE0) between 1990 and 2013. DESIGN:Retrospective demographic analysis based on aggregated data and using life table technique, Sullivan method, and decomposition method for diff...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.l969

    authors: Chen H,Chen G,Zheng X,Guo Y

    更新日期:2019-03-27 00:00:00

  • Use of vitamin B-12 in Leicestershire practices: a single topic audit led by a medical audit advisory group.

    abstract:OBJECTIVE:To encourage active participation of Leicestershire general practitioners and their staff in audit; to examine the use of vitamin B-12 injections and to achieve a more appropriate use. DESIGN:Implementation of an agreed audit protocol, with central analysis and feedback of anonymous and aggregated data by a ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.311.6996.28

    authors: Fraser RC,Farooqi A,Sorrie R

    更新日期:1995-07-01 00:00:00

  • Impact of late diagnosis and treatment on life expectancy in people with HIV-1: UK Collaborative HIV Cohort (UK CHIC) Study.

    abstract:OBJECTIVES:To estimate life expectancy for people with HIV undergoing treatment compared with life expectancy in the general population and to assess the impact on life expectancy of late treatment, defined as CD4 count <200 cells/mm(3) at start of antiretroviral therapy. DESIGN:Cohort study. SETTING:Outpatient HIV c...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.d6016

    authors: May M,Gompels M,Delpech V,Porter K,Post F,Johnson M,Dunn D,Palfreeman A,Gilson R,Gazzard B,Hill T,Walsh J,Fisher M,Orkin C,Ainsworth J,Bansi L,Phillips A,Leen C,Nelson M,Anderson J,Sabin C

    更新日期:2011-10-11 00:00:00

  • Molecular investigation into outbreak of HIV in a Scottish prison.

    abstract:OBJECTIVES:To support already established epidemiological links between inmates of Glenochil prison positive for HIV infection by using molecular techniques and thus provide evidence of the extent of acquisition during a recent outbreak of the disease resulting from needle sharing. To identify possible sources of the o...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.314.7092.1446

    authors: Yirrell DL,Robertson P,Goldberg DJ,McMenamin J,Cameron S,Leigh Brown AJ

    更新日期:1997-05-17 00:00:00

  • Admissions processes for five year medical courses at English schools: review.

    abstract:OBJECTIVE:To describe the current methods used by English medical schools to identify prospective medical students for admission to the five year degree course. DESIGN:Review study including documentary analysis and interviews with admissions tutors. SETTING:All schools (n = 22) participating in the national expansio...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.38768.590174.55

    authors: Parry J,Mathers J,Stevens A,Parsons A,Lilford R,Spurgeon P,Thomas H

    更新日期:2006-04-29 00:00:00

  • Written informed consent and selection bias in observational studies using medical records: systematic review.

    abstract:OBJECTIVES:To determine whether informed consent introduces selection bias in prospective observational studies using data from medical records, and consent rates for such studies. DESIGN:Systematic review. DATA SOURCES:Embase, Medline, and the Cochrane Library up to March 2008, reference lists from pertinent article...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.b866

    authors: Kho ME,Duffett M,Willison DJ,Cook DJ,Brouwers MC

    更新日期:2009-03-12 00:00:00

  • Trial of support treatment with human chorionic gonadotrophin in the luteal phase after treatment with buserelin and human menopausal gonadotrophin in women taking part in an in vitro fertilisation programme.

    abstract:OBJECTIVE:To evaluate the effect of support with human chorionic gonadotrophin in the luteal phase in women taking part in an in vitro fertilisation programme after buserelin and human menopausal gonadotrophin were used to hyperstimulate their ovaries. DESIGN:Controlled group comparison. SETTING:Outpatient department...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章

    doi:10.1136/bmj.298.6686.1483

    authors: Smith EM,Anthony FW,Gadd SC,Masson GM

    更新日期:1989-06-03 00:00:00

  • Intergenerational 20 year trends in the prevalence of asthma and hay fever in adults: the Midspan family study surveys of parents and offspring.

    abstract:OBJECTIVE:To estimate trends between 1972-6 and 1996 in the prevalences of asthma and hay fever in adults. DESIGN:Two epidemiological surveys 20 years apart. Identical questions were asked about asthma, hay fever, and respiratory symptoms at each survey. SETTING:Renfrew and Paisley, two towns in the west of Scotland....

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.321.7253.88

    authors: Upton MN,McConnachie A,McSharry C,Hart CL,Smith GD,Gillis CR,Watt GC

    更新日期:2000-07-08 00:00:00

  • Psychosis with good prognosis in Afro-Caribbean people now living in the United Kingdom.

    abstract:OBJECTIVES:To compare the course and outcome of psychotic illness in a group of Afro-Caribbean patients resident in the United Kingdom and a group of white British patients. DESIGN:Cohort study of consecutive admissions followed up for four years. SUBJECTS:113 patients with psychotic illness of recent onset admitted ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.311.7016.1325

    authors: McKenzie K,van Os J,Fahy T,Jones P,Harvey I,Toone B,Murray R

    更新日期:1995-11-18 00:00:00

  • Performance of alternative strategies for primary cervical cancer screening in sub-Saharan Africa: systematic review and meta-analysis of diagnostic test accuracy studies.

    abstract:OBJECTIVE:To assess and compare the accuracy of visual inspection with acetic acid (VIA), visual inspection with Lugol's iodine (VILI), and human papillomavirus (HPV) testing as alternative standalone methods for primary cervical cancer screening in sub-Saharan Africa. DESIGN:Systematic review and meta-analysis of dia...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.h3084

    authors: Fokom-Domgue J,Combescure C,Fokom-Defo V,Tebeu PM,Vassilakos P,Kengne AP,Petignat P

    更新日期:2015-07-03 00:00:00

  • Economic evaluation of hospital at home versus hospital care: cost minimisation analysis of data from randomised controlled trial.

    abstract:OBJECTIVES:To compare the costs of admission to a hospital at home scheme with those of acute hospital admission. DESIGN:Cost minimisation analysis within a pragmatic randomised controlled trial. SETTING:Hospital at home scheme in Leicester and the city's three acute hospitals. PARTICIPANTS:199 consecutive patients ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.319.7224.1547

    authors: Jones J,Wilson A,Parker H,Wynn A,Jagger C,Spiers N,Parker G

    更新日期:1999-12-11 00:00:00

  • Does the decline in child injury mortality vary by social class? A comparison of class specific mortality in 1981 and 1991.

    abstract:OBJECTIVE:To examine whether the decline in child injury death rates between 1981 and 1991 varied by social class. DESIGN:Comparison of class specific child injury death rates for 1979, 1980, 1982, and 1983, with those for the four years 1989-92. SETTING:England and Wales. SUBJECTS:Children aged 0-15 years. MAIN OU...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.313.7060.784

    authors: Roberts I,Power C

    更新日期:1996-09-28 00:00:00

  • Accuracy of diagnosis of psychosis on general practice computer system.

    abstract:OBJECTIVES:To determine the accuracy of diagnoses of schizophrenia and non-affective psychosis entered by general practitioners on a computer system. To compare recording of clinical events on computer with written records. DESIGN:Examination of case notes of all patients with a computer diagnosis of psychosis. Search...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.307.6895.32

    authors: Nazareth I,King M,Haines A,Rangel L,Myers S

    更新日期:1993-07-03 00:00:00

  • Prevalence of asymptomatic myocardial ischaemia in diabetic subjects.

    abstract:OBJECTIVE:To compare the prevalence of silent myocardial ischaemia associated with coronary artery disease in diabetic subjects with that in controls of similar age and sex. DESIGN:A controlled study in which subjects with positive findings on exercise electrocardiography, 24 hour electrocardiographic recording, or dy...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.301.6743.92

    authors: Koistinen MJ

    更新日期:1990-07-14 00:00:00

  • Assessment of the genetic and clinical determinants of fracture risk: genome wide association and mendelian randomisation study.

    abstract:OBJECTIVES:To identify the genetic determinants of fracture risk and assess the role of 15 clinical risk factors on osteoporotic fracture risk. DESIGN:Meta-analysis of genome wide association studies (GWAS) and a two-sample mendelian randomisation approach. SETTING:25 cohorts from Europe, United States, east Asia, an...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.k3225

    authors: Trajanoska K,Morris JA,Oei L,Zheng HF,Evans DM,Kiel DP,Ohlsson C,Richards JB,Rivadeneira F,GEFOS\/GENOMOS consortium and the 23andMe research team.

    更新日期:2018-08-29 00:00:00

  • Investigation of growth, development, and factors associated with injury in elite schoolboy footballers: prospective study.

    abstract:OBJECTIVE:To investigate the differences between skeletal and chronological age and to assess the role of maturity status, anthropometric data, and football related variables in explaining injury statistics in elite schoolboy footballers. DESIGN:Prospective study of injuries in schoolboy footballers according to skele...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.b490

    authors: Johnson A,Doherty PJ,Freemont A

    更新日期:2009-02-26 00:00:00

  • The impact of patients' preferences on the treatment of atrial fibrillation: observational study of patient based decision analysis.

    abstract:OBJECTIVE:To investigate the impact of patients' preferences for the treatment of atrial fibrillation, by using individualised decision analysis combining probability and utility assessments into a decision tree. DESIGN:Observational study based on interviews with patients. SETTING:Eight general practices in Avon. P...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.320.7246.1380

    authors: Protheroe J,Fahey T,Montgomery AA,Peters TJ

    更新日期:2000-05-20 00:00:00

  • Differences in incomes of physicians in the United States by race and sex: observational study.

    abstract:OBJECTIVES: To estimate differences in annual income of physicians in the United States by race and sex adjusted for characteristics of physicians and practices. DESIGN: Cross sectional survey study. SETTING: Nationally representative samples of US physicians. PARTICIPANTS: The 2000-13 American Community Survey (ACS...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.i2923

    authors: Ly DP,Seabury SA,Jena AB

    更新日期:2016-06-07 00:00:00

  • Risk of presentation to hospital with epileptic seizures after vaccination with monovalent AS03 adjuvanted pandemic A/H1N1 2009 influenza vaccine (Pandemrix): self controlled case series study.

    abstract:OBJECTIVE:To assess the risk of epileptic seizures in people with and without epilepsy after vaccination with a monovalent AS03 adjuvanted pandemic A/H1N1 influenza vaccine (Pandemrix; Glaxo SmithKline, Sweden). DESIGN:Register based self controlled case series. SETTING:Three Swedish counties (source population 750,0...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.e7594

    authors: Arnheim-Dahlström L,Hällgren J,Weibull CE,Sparén P

    更新日期:2012-12-18 00:00:00

  • Compression ultrasonography for diagnostic management of patients with clinically suspected deep vein thrombosis: prospective cohort study.

    abstract:OBJECTIVE:To evaluate the safety of withholding anticoagulant treatment from patients with clinically suspected deep vein thrombosis but normal findings on compression ultrasonography. DESIGN:Compression ultrasonography was done with a simplified diagnostic procedure limited to the common femoral vein in the groin and...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.316.7124.17

    authors: Cogo A,Lensing AW,Koopman MM,Piovella F,Siragusa S,Wells PS,Villalta S,Büller HR,Turpie AG,Prandoni P

    更新日期:1998-01-03 00:00:00

  • Introducing the Internet.

    abstract::The benefits to medical practitioners of using the Internet are growing rapidly as the Internet becomes easier to use and ever more biomedical resources become available on line. The Internet is the largest computer network in the world; it is also a virtual community, larger than many nation states, with its own rule...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.311.7017.1422

    authors: Pallen M

    更新日期:1995-11-25 00:00:00

  • Right-left discrimination among medical students: questionnaire and psychometric study.

    abstract:OBJECTIVE:To determine medical students' self awareness and ability to discriminate right from left; to identify characteristics associated with this ability; and to identify any techniques used to aid discrimination. DESIGN:Questionnaire and psychometric study. SETTING:Undergraduate medical school, Northern Ireland....

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.a2826

    authors: Gormley GJ,Dempster M,Best R

    更新日期:2008-12-16 00:00:00

  • Pertussis immunisation and serious acute neurological illnesses in children.

    abstract:OBJECTIVE:To determine long term outcome in children who had a severe acute neurological illness in early childhood associated with pertussis immunisation. DESIGN:Follow up study of cases and matched controls. SETTING:Assessment of children at home and at school throughout Britain. SUBJECTS:Children recruited into t...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.307.6913.1171

    authors: Miller D,Madge N,Diamond J,Wadsworth J,Ross E

    更新日期:1993-11-06 00:00:00