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Articles by G. L Larkin
Total Records ( 3 ) for G. L Larkin
  P. D Levy , H Ye , S Compton , P. S Chan , G. L Larkin , R. D Welch and for the American Heart Association National Registry of Cardiopulmonary Resuscitation Investigators
 

Background— Hospitalized patients with heart failure are at risk for cardiac arrest. The ability to predict who may survive such an event with or without neurological deficit would enhance the information on which patients and providers establish resuscitative preferences.

Methods and Results— We identified 13 063 adult patients with acute heart failure who had cardiac arrest at 457 hospitals participating in the National Registry of Cardiopulmonary Resuscitation between January 1, 2000 and December 31, 2007. Neurological status was determined on admission and discharge by cerebral performance category with neurologically intact survival (NIS)=cerebral performance category 1 (no) or 2 (moderate dysfunction) and non-NIS=cerebral performance category 3 (severe dysfunction), 4 (coma), or 5 (brain death). Factors available prearrest (demographics, preexisting conditions, and interventions in-place) were assessed for association with NIS using multivariable logistic regression, initially without then with adjustment for arrest-related variables and hospital characteristics. NIS occurred in 2307 patients (17.7%) and was associated by adjusted odds ratio with 18 prearrest factors; 4 positively and 14 negatively. The association (odds ratio; 95% CI) was strongest for 4 specific variables: acute stroke (0.38; 0.25 to 0.58), history of malignancy (0.49; 0.39 to 0.63), vasopressor use (0.50; 0.43 to 0.59), and assisted or mechanical ventilation (0.53; 0.45 to 0.61).

Conclusions— A number of prearrest factors seem to be associated with NIS, the majority inversely. Consideration of these before cardiac arrest could enhance the resuscitative decision-making process for patients with acute heart failure.

  C. A Claassen , T Carmody , S. M Stewart , R. M Bossarte , G. L Larkin , W. A Woodward and M. H. Trivedi
 

Background

The terrorist attacks in the USA on 11 September 2001 affected suicide rates in two European countries, whereas overall US rates remained stable. The effect on attack site rates, however, has not been studied.

Aims

To examine post-attack suicide rates in areas surrounding the three airline crash sites.

Method

Daily mortality rates were modelled using time series techniques. Where rate change was significant, both duration and geographic scope were analysed.

Results

Around the World Trade Center, post-attack 180-day rates dropped significantly (t = 2.4, P = 0.0046), whereas comparison condition rates remained stable. No change was observed for Pentagon or Flight 93 crash sites.

Conclusions

The differential effect by site suggests that proximity may be less important that other event characteristics. Both temporal and geographic aspects of rate fluctuation after sentinel events appear measurable and further analyses may contribute valuable knowledge about how sociological forces affect these rates.

 
 
 
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