GLORIA

GEOMAR Library Ocean Research Information Access

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
Filter
  • Ovid Technologies (Wolters Kluwer Health)  (7)
Material
Publisher
  • Ovid Technologies (Wolters Kluwer Health)  (7)
Language
Years
Subjects(RVK)
  • 1
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 54, No. Suppl_1 ( 2023-02)
    Abstract: Introduction: Early ICH expansion is associated with a higher rate of poor outcomes and death in aSAH patients, especially in limited-resource settings. This study aimed to investigate the impact of ICH expansion on the outcomes and the factors related to an ICH expansion in aSAH patients in an LMIC. Hypothesis: Understanding factors related to ICH after an aneurysmal rupture in different countries, particularly in limited-resource regions, is crucial for reducing poor outcomes and mortality. Methods: We performed a multicenter prospective cohort study of patients (≥18 years) presenting with aSAH at three central hospitals in Hanoi, Vietnam, from August 2019 to June 2021. We collected data on the demographics, baseline characteristics, management, and outcomes and compared these data between patients who had an ICH expansion (defined as ICH detected on an admission CT scan) and patients who did not. We assessed factors associated with ICH expansion on admission using logistic regression. Results: Of 415 patients, 198 (47.7%) were men, and the median age was 57.0 years (IQR: 48.0-67.0). ICH expansion accounted for 20.5% (85/415) of aSAH patients. There was a significant difference in the 90-day poor outcomes (43.5%; 37/85 and 29.1%; 96/330; p=0.011) and 90-day mortality (36.5%; 31/85 and 20.0%; 66/330; p=0.001) between patients who had ICH and patients who did not have ICH expansion. The multivariate analysis showed that systolic BP of 140 mmHg or more (OR: 2.674; 95% CI: 1.372-5.214), WFNS grades II (OR: 3.683; 95% CI: 1.250-10.858) to V (OR: 6.912; 95% CI: 2.553-18.709), and a ruptured MCA aneurysm (OR: 3.717; 95% CI: 1.848-7.477) were independent predictors of ICH expansion. Conclusions: In our study, ICH accounted for a substantial proportion of aSAH patients and contributed significantly to a high rate of poor outcomes and death. On admission, a higher systolic BP, a worse neurological status, and a ruptured MCA aneurysm were independent predictors of ICH expansion. This study indicates independent predictors of an early ICH expansion, such as a higher admission systolic BP and a worse initial neurological status, after aneurysmal ruptures that require only a clinical examination and, therefore, may be particularly valuable in resource-limited settings.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 2
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 55, No. Suppl_1 ( 2024-02)
    Abstract: Introduction: Evaluating the prognosis of aSAH patients who may be at risk of poor outcomes using grading systems is one way to make a better decision on treatment for these patients. This study compared the accuracy of modified WFNS, WFNS, and Hunt and Hess (H & H) scales in predicting the aSAH patient's outcome. Methods: From August 2019 to June 2021, we conducted a multicenter prospective cohort study on aSAH adult patients in three central hospitals in Hanoi, Vietnam. The primary outcome was the 90-day poor outcome, measured by scores of 4-6 on mRS. We calculated areas under the receiver operator characteristic (ROC) curve (AUROCs) to determine how well the grading scales could predict patient prognosis upon admission. We also used ROC curve analysis to find the best cut-off value for each scale. We made comparisons of AUROCs using Z-statistics and compared 90-day mean mRS scores among intergrades using the pairwise multiple-comparison test. Finally, we used logistic regression to identify factors associated with the 90-day poor outcome. Results: Of 415 patients, 32% had a 90-day poor outcome. Modified WFNS (AUROC: 0.839 [95% CI: 0.795-0.883]; cut-off value≥2.50), WFNS (AUROC: 0.837 [95% CI: 0.793-0.881] ; cut-off value≥3.5), and H & H scales (AUROC: 0.836 [95% CI: 0.791-0.881]; cut-off value≥3.5) were all good at predicting patient prognosis on day 90th after ictus. However, there were no significant differences between AUROCs of these scales. Only grades IV and V of modified WFNS (3.75±2.46 vs. 5.24±1.68, p=0.026), WFNS (3.75±2.46 vs. 5.24±1.68, p=0.026), and H & H scales (2.96±2.60 vs. 4.97±1.87, p 〈 0.001) showed a significant difference in the 90-day mean mRS scores. In the multivariable models, with the same set of confounding variables, modified WFNS grade of III-V (adjusted OR (AOR): 9.090; 95% CI: 3.494-23.648) was more strongly associated with increased risk of the 90-day poor outcome compared to WFNS grade of IV-V (AOR: 6.383; 95% CI: 2.661-15.310) or H & H grade of IV-V (AOR: 6.146; 95% CI: 2.584-14.620). Conclusions: In this study modified WFNS, WFNS, and H & H scales all had good discriminatory abilities for the prognosis of aSAH patients. Because of better effect size in predicting poor outcomes, the modified WFNS scale seems preferable to the WFNS and H & H scales.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2024
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 3
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_4 ( 2020-11-17)
    Abstract: Introduction: Pre-hospital capabilities are minimally developed in Vietnam; therefore, the prognosis of OHCA might differ from that of other countries. The aim of this study was to investigate survival rate from OHCA and potential determinants of the chain of survival following an OHCA in a developing country. Hypothesis: Understanding the country-specific etiologies and the disease risk and prognosis of OHCA are crucial for reducing mortality in Vietnam, as well as in other countries that face challenges in clinical practice owing to limited medical resources. Methods: This is a multi-center prospective observational study of OHCA patients (age 〉 18 years) presenting to the ED of three tertiary hospitals from February 2014 to December 2018. Factors associated with survival following OHCA were collected and compared among types of pre-hospital care transportation and between survival and non-survival to admission. Factors for survival to admission were assessed using logistic regression analysis. Results: Among 590 OHCA patients (male, 74.6%; age, 56.1±17.2 years), we observed low rates of survival to admission (24.2%) and discharge (14.1%). Of total patients, 67.8% occurred at home, 79.4% witnessed by bystanders, 124/555 (22.3%) received bystander CPR, a minority of patients (8.64%) was conveyed by EMS, and 49/152 (32.2%) received pre-hospital defibrillation. Multivariate analysis revealed that past medical history (PMH) of respiratory disease (OR, 3.128; 95% CI, 1.197-8.173), pre-hospital defibrillation (OR, 3.904; 95% CI, 1.540-9.898), pre-hospital advanced airway (OR, 3.441; 95% CI, 1.203-9.844) and ROSC at ED (OR, 2.891; 95% CI, 1.030-8.115) were independent factors for survival to admission. Following OHCA with cardiac etiology, EMS use (OR, 0.203; 95% CI, 0.044-0.935) was also an independent factor for survival to admission. Conclusions: This was a highly selected cohort of OHCA patients presenting to the ED. Many OHCA victims in Vietnam do not come to the ED. PMH of respiratory disease, pre-hospital defibrillation and advanced airway, and ROSC at ED were independent factors predicting survival to admission. EMS use was also an inverse and independent predictor of survival to admission among patients following OHCA with cardiac etiology.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 4
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Introduction: Bystander CPR is not often performed on OHCA patients, particularly in limited-resource regions. This study aimed to investigate the rate of OHCA patients who did not receive bystander CPR and its impact on the outcomes in an LMIC. Hypothesis: Understanding the reasons bystanders are reluctant to call EMS and how no bystander CPR impacts the outcomes of OHCA patients are crucial for improving survival in Vietnam. Methods: We performed a multicenter prospective cohort study of OHCA patients (≥18 years) presenting to three central hospitals in Vietnam from February 2014 to December 2018. We collected data on characteristics, management, and outcomes and compared these data between patients who did not receive bystander CPR and patients who did. Using logistic regression, we assessed factors associated with survival and good neurological function on discharge (a CPC score of 1 or 2). Results: Of 521 patients, 388 (74.5%) were male, and the mean age was 56.71 years (SD: 17.32). Although most cardiac arrests (68.7%; 358/521) occurred at home and 67.9% (353/520) were witnessed by bystanders, a high rate (77.9%, 406/521) of these patients did not receive bystander CPR. Only half of the patients were taken by EMS (8.1%, 42/521) or private ambulance (42.8%, 223/521); 50.8% (133/262) of whom were given resuscitation attempts by EMS or private ambulance. There was no significant difference in survival to admission (16.7%; 68/406 and 24.3%; 28/115; p=0.064) and survival to discharge (7.9%; 32/406 and 14.8%; 17/115; p=0.094) between patients who did not receive bystander CPR and patients who did. In contrast, the rate of good neurological function of patients who did not receive bystander CPR (4.7%, 19/406) was significantly lower than that of patients who received bystander CPR (12.2%, 14/115; p=0.004). Moreover, multivariate analysis showed that no bystander CPR (OR: 0.276; 95% CI: 0.124-0.614) was inversely and independently associated with good neurological function. Conclusions: In our study, poor outcomes emphasize the need for increasing bystander CPR performance, increasing the number of EMS ambulances and the utilization of private ambulances, and developing a standard emergency first-aid program for both healthcare personnel and the community.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 5
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_2 ( 2021-11-16)
    Abstract: Introduction: Pre-hospital services are not well developed in Vietnam, especially the immature of a trauma system of care. The prognosis of traumatic out-of-hospital cardiac arrest (OHCA) might differ from that of other countries. This study aimed to investigate the survival rate from traumatic OHCA and to measure the critical components of the chain of survival following a traumatic OHCA in the country. Hypothesis: Although the outcome in cardiac arrest following trauma is dismal, pre-hospital resuscitation efforts are not futile and seem worthwhile. Understanding the country-specific causes, risk, and prognosis of traumatic OHCA is important to reduce mortality in Vietnam. Methods: We performed a multicenter prospective observational study of consecutive patients ( 〉 16 years) presenting with traumatic OHCA to 3 central hospitals in Vietnam from February 2014 to December 2018. We collected data on characteristics, management, and outcomes of patients with traumatic OHCA and compared these data between patients who died before hospital discharge and patients who survived to discharge from the hospital. Results: Of 111 eligible patients with traumatic OHCA, 92 (82.9%) were male and the mean age was 39.27 years (standard deviation: 16.38). Only 5.4% (6/111) survived to discharge from the hospital. Most cardiac arrests (62.2%; 69/111) occurred on the street or highway, 31.2% (29/93) were witnessed by bystanders, and 33.7% (32/95) were given cardiopulmonary resuscitation (CPR) by a bystander. Only 26.1% (29/111) of the patients were taken by the emergency medical services (EMS), 90% (27/30) received pre-hospital advanced airway, and 54.7% (29/53) were given resuscitation attempts by EMS or private ambulance. No significant difference between patients who died before hospital discharge and patients who survived to discharge from the hospital was found for bystander CPR (33.7%, 30/89 and 33.3%, 2/6, P 〉 0.999; respectively) and resuscitation attempts (56.3%, 27/48, and 40.0%, 2/5, P=0.649; respectively). Conclusion: Improvements are needed in the EMS in Vietnam, such as increasing bystander first-aid and developing a trauma system of care, as well as developing a standard emergency first-aid program for both healthcare personnel and the community.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 6
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Annals of Plastic Surgery Vol. 73, No. 4 ( 2014-10), p. 412-415
    In: Annals of Plastic Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 73, No. 4 ( 2014-10), p. 412-415
    Type of Medium: Online Resource
    ISSN: 0148-7043
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 2063013-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 7
    In: Annals of Plastic Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 87, No. 3 ( 2021-9), p. 343-347
    Abstract: Current disease surveillance in Vietnam relies on underdeveloped electronic medical record (EMR) systems, which are insufficient for timely standardized data collection about craniofacial and cleft pathologies. Concurrently, the World Bank reports Vietnamese mobile cellular subscription rates (per 100 people) of 128, some of the highest in the world. Herein, we discuss the development of a short messaging service (SMS)–based surveillance system based in Hanoi, Vietnam, and its utility in contrast to an EMR-based approach to craniofacial epidemiology study. Methods Vietnam National Children's Hospital (VNCH) is a pediatric tertiary care center serving approximately 12 million children. Four plastic surgeons were trained in SMS data entry. The SMS database was designed using FrontlineSMS, a 2-way mobile gateway software application with automated messaging capabilities. The VNCH EMR database was queried for individual demographic data for patients seen by the department from 2010 to 2019. Results A corrected prevalence for cleft lip and palate of 0.098% (1 in 1020 live births) was calculated based on EMR data. Six rural provinces greater than 150 km from Hanoi were found to be significantly ( P 〈 0.01) underserved surgically by the VNCH. A significantly ( P 〈 0.01) higher rate of Pierre Robin in Lang Son province and facial clefts in Ha Tinh province were identified. The prospective data collection system received 7 patient data sets over 4 months, resulting in a capture rate of 2.9%. Conclusions This feasibility study offers valuable insight into the true cleft and craniofacial prevalence in Vietnam and alternative methods to study in low- and middle-income countries.
    Type of Medium: Online Resource
    ISSN: 1536-3708 , 0148-7043
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2063013-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...