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
BMJjournal_title
BMJ (Clinical research ed.)authors
Norris RMsubject
Has Abstractpub_date
1998-04-04 00:00:00pages
1065-70issue
7137eissn
0959-8138issn
1756-1833journal_volume
316pub_type
杂志文章,多中心研究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
更新日期:2019-12-11 00:00:00
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
更新日期:2015-10-21 00:00:00
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
更新日期:1990-03-03 00:00:00
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 ...
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pub_type: 杂志文章
doi:10.1136/bmj.39059.594444.AE
更新日期:2007-02-10 00:00:00
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...
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pub_type: 杂志文章
doi:10.1136/bmj.315.7106.449
更新日期:1997-08-23 00:00:00
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
更新日期:2007-11-03 00:00:00
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
更新日期:1996-02-24 00:00:00
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
更新日期:2019-03-27 00:00:00
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 ...
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pub_type: 杂志文章
doi:10.1136/bmj.311.6996.28
更新日期:1995-07-01 00:00:00
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...
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pub_type: 杂志文章
doi:10.1136/bmj.d6016
更新日期:2011-10-11 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
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更新日期:1997-05-17 00:00:00
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
更新日期:2006-04-29 00:00:00
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...
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pub_type: 杂志文章,评审
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更新日期:2009-03-12 00:00:00
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
更新日期:1989-06-03 00:00:00
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....
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doi:10.1136/bmj.321.7253.88
更新日期:2000-07-08 00:00:00
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
更新日期:1995-11-18 00:00:00
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...
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pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.h3084
更新日期:2015-07-03 00:00:00
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
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pub_type: 杂志文章,meta分析
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更新日期:2018-08-29 00:00:00
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更新日期:2009-02-26 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.320.7246.1380
更新日期:2000-05-20 00:00:00
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更新日期:2016-06-07 00:00:00
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doi:10.1136/bmj.e7594
更新日期:2012-12-18 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.316.7124.17
更新日期:1998-01-03 00:00:00
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pub_type: 杂志文章,评审
doi:10.1136/bmj.311.7017.1422
更新日期:1995-11-25 00:00:00
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....
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pub_type: 杂志文章
doi:10.1136/bmj.a2826
更新日期:2008-12-16 00:00:00
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pub_type: 杂志文章
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更新日期:1993-11-06 00:00:00