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  • 1.
    Bertilsson, Emelie
    et al.
    Kalmar County Hospital.
    Semark, Birgitta
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bremer, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Usage of Do-not-attempt-to resuscitate-orders in a Swedish community hospital: patient involvement, documentation and compliance2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, p. e93-e94Article in journal (Refereed)
  • 2.
    Bremer, Anders
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council.
    Dahné, Tova
    Linköping University.
    Stureson, Lovisa
    Linköping University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council.
    Thylén, Ingela
    Linköping University.
    Lived experiences of surviving in-hospital cardiac arrest2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, p. e122-e122Article in journal (Refereed)
  • 3.
    Hjelm, Carina
    et al.
    Linköping University.
    Hellström, Amanda
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Broström, Anders
    Jönköping University ; Linköping University Hospital.
    Bremer, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Exploring sleep disturbances in cardiac arrest survivors: a phenomenographic interview study from registered nurses’ perspective2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, p. e129-e129Article in journal (Refereed)
  • 4.
    Israelsson, Johan
    et al.
    Kalmar County Hospital, Sweden.
    Bremer, Anders
    University of Borås, Sweden.
    Axelsson, Åsa
    University of Gothenburg, Sweden.
    Cronberg, Tobias
    Lund University, Sweden.
    Djärv, Therese
    Karolinska Institutet, Sweden.
    Herlitz, Johan
    University of Borås, Sweden.
    Kristofferzon, Marja-Leena
    University of Gävle, Sweden.
    Larsson, Ing-Marie
    Uppsala University, Sweden.
    Lilja, Gisela
    Lund University, Sweden.
    Sunnerhagen, Katarina S
    University of Gothenburg, Sweden.
    Wallin, Ewa
    Uppsala University, Sweden.
    Ågren, Susanna
    Linköping University, Sweden.
    Åkerman, Eva
    Skåne University Hospital, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Neurologic outcome, health-related quality of life, anxiety and symptoms of depression among in-hospital cardiac arrest survivors2015In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 96, no S1, p. 101-101Article in journal (Refereed)
    Abstract [en]

    Purpose: Most cardiac arrest research has focused on survival in an out-of-hospital context. The knowledge of health and quality of life is sparse, especially regarding in-hospital cardiac arrest (IHCA) survivors. The aim of the current study was therefore to describe neurologic outcome, health-related quality of life (HRQoL), anxiety and symptoms of depression among IHCA survivors.

    Materials and methods: This study has a cross-sectional design. Data from the Swedish Register of Cardiopulmonary Resuscitation was used. In the register, data is collected 3–6 months after resuscitation by using a questionnaire including two questions about activities in daily life and mental/intellectual recovery, the EQ-5D-5L and the Hospital Anxiety and Depression Scale (HADS). In addition, Cerebral Performance Category (CPC)-scoring is performed.

    Results: Between the 11th of June 2013 and the 7th of May 2015, 488 IHCA survivors with a mean age of 69 ± 13 were included. A majority were men (62%), had a cerebral function of CPC 1 (87%) and no need of assistance from other people in daily life (71%). A large proportion had not made a complete mental/intellectual recovery (27%). Pain/discomfort was the dimension in EQ-5D-5L where most survivors reported problems (64%), while least problems were reported in the dimension self-care (24%). The individual variations of present health state (EQ-VAS) were substantial (range 0–100), with a mean value of 66 ± 22. Anxiety and symptoms of depression were reported by 16% and 15% respectively.

    Conclusions: Although the majority of the IHCA survivors reported good neurologic outcome, satisfactory HRQoL, no anxiety or symptoms of depression, the results indicate major individual differences, with a substantial group reporting serious problems. Our findings stress the importance of structured post resuscitation care and follow-up, in order to identify and support those in need.

  • 5.
    Israelsson, Johan
    et al.
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Hospital, Sweden;Linköping University, Sweden.
    Bremer, Anders
    University of Borås, Sweden;Kalmar County Hospital, Sweden.
    Herlitz, Johan
    University of Borås, Sweden.
    Axelsson, Åsa B.
    University of Gothenburg, Sweden.
    Cronberg, Tobias
    Lund University, Sweden.
    Djärv, Therese
    Karolinska Institutet, Sweden;Karolinska University Hospital, Sweden.
    Kristofferzon, Marja-Leena
    University of Gävle, Sweden;Uppsala University, Sweden.
    Larsson, Ing-Marie
    Uppsala University, Sweden.
    Lilja, Gisela
    Lund University, Sweden.
    Sunnerhagen, Katharina S.
    University of Gothenburg, Sweden.
    Wallin, Ewa
    Uppsala University, Sweden.
    Ågren, Susanna
    Linköping University, Sweden;County Council of Östergötland, Sweden.
    Åkerman, Eva
    Skåne University Hospital, Sweden;Karolinska Institutet, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Ersta Sköndal Bräcke University College, Sweden;Kalmar County Hospital, Sweden.
    Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender2017In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 114, p. 27-33Article in journal (Refereed)
    Abstract [en]

    AIM: To describe health status and psychological distress among in-hospital cardiac arrest (IHCA) survivors in relation to gender.

    METHODS: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS).

    RESULTS: Between 2013 and 2015, 594 IHCA survivors were included in the study. The median values for EQ-5D-5L index and EQ VAS among survivors were 0.78 (q1-q3=0.67-0.86) and 70 (q1-q3=50-80) respectively. The values were significantly lower (p<0.001) in women compared to men. In addition, women reported more problems than men in all dimensions of EQ-5D-5L, except self-care. A majority of the respondents reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (p<0.001) and symptoms of depression (p<0.001) compared to men. Gender was significantly associated with poorer health status and more psychological distress. No interaction effects for gender and age were found.

    CONCLUSIONS: Although the majority of survivors reported acceptable health status and no psychological distress, a substantial proportion reported severe problems. Women reported worse health status and more psychological distress compared to men. Therefore, a higher proportion of women may be in need of support. Health care professionals should make efforts to identify health problems among survivors and offer individualised support when needed.

  • 6.
    Israelsson, Johan
    et al.
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Department of Cardiology, Kalmar County Council, Kalmar ; Linköping University.
    Thylén, Ingela
    Linköping University.
    Strömberg, Anna
    Linköping University.
    Bremer, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Division of Emergency Medical Services, Kalmar County Council, Kalmar.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. The Research Section, Kalmar County Council, Kalmar.
    Factors associated with health status and psychological distress among cardiac arrest survivors treated with an implantable cardioverter-defibrillator2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, p. e85-Article in journal (Refereed)
  • 7.
    Israelsson, Johan
    et al.
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Council;Linköping university.
    Thylén, Ingela
    Linköping university.
    Strömberg, Anna
    Linköping university.
    Bremer, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council.
    Factors associated with health-related quality of life among cardiac arrest survivors treated with an implantable cardioverter-defibrillator2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 132, p. 78-84Article in journal (Refereed)
    Abstract [en]

    Aim

    To explore factors associated with health-related quality of life (HRQoL) among cardiac arrest (CA) survivors treated with an implantable cardioverter-defibrillator (ICD) in relation to gender, and to compare their HRQoL with a general population.

    Methods

    This cross-sectional study included 990 adults treated with an ICD after suffering CA. All participants received a questionnaire including demographics, comorbidities and instruments to measure HRQoL (EQ-5D-3L and HADS), ICD-related concerns (ICDC), perceived control (CAS), and type D personality (DS-14). HRQoL (EQ-5D-3L) was compared to a general Swedish population, matched for age and gender. Linear regression analyses were used to explore factors associated with HRQoL.

    Results

    The CA survivors reported better HRQoL in EQ index and less pain/discomfort compared to the general population (p < 0.001). In contrast, they reported more problems in mobility and usual activities (p < 0.01). Problems with anxiety and depression were reported by 15.5% and 7.4% respectively. The following factors were independently associated with all aspects of worse HRQoL: being unemployed, suffering more comorbidity, perceiving less control, and having a type D personality. Further, being female and suffering ICD-related concerns were independently associated with worse HRQoL in three of the four final regression models.

    Conclusions

    This extensive population-based study showed that most CA survivors living with an ICD rate their HRQoL as acceptable. In addition, their HRQoL is similar to a general population. Women reported worse HRQoL compared to men. Several factors associated with HRQoL were identified, and might be used when screening patients for health problems and when developing health promoting interventions.

  • 8.
    Israelsson, Johan
    et al.
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Hospital ; Linköping University.
    von Wangenheim, Burkard
    Kalmar County Hospital.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Semark, Birgitta
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital.
    Sensitivity and specificity of two different automated external defibrillators2017In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 120, p. 108-112Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to investigate the clinical performance of two different types of automated external defibrillators (AEDs). Methods: Three investigators reviewed 2938 rhythm analyses performed by AEDs in 240 consecutive patients (median age 72, q1-q3 = 62-83) who had suffered cardiac arrest between January 2011 and March 2015. Two different AEDs were used (AED A n = 105, AED B n = 135) in-hospital (n = 91) and out-of-hospital (n = 149). Results: Among 194 shockable rhythms, 17 (8.8%) were not recognized by AED A, while AED B recognized 100% (n = 135) of shockable episodes (sensitivity 91.2 vs 100%, p < 0.01). In AED A, 8 (47.1%) of these episodes were judged to be algorithm errors while 9 (52.9%) were caused by external artifacts. Among 1039 non-shockable rhythms, AED A recommended shock in 11 (1.0%), while AED B recommended shock in 63 (4.1%) of 1523 episodes (specificity 98.9 vs 95.9, p < 0.001). In AED A, 2 (18.2%) of these episodes were judged to be algorithm errors (AED B, n = 40, 63.5%), while 9 (81.8%) were caused by external artifacts (AED B, n = 23, 36.5%). Conclusions: There were significant differences in sensitivity and specificity between the two different AEDs. A higher sensitivity of AED B was associated with a lower specificity while a higher specificity of AED A was associated with a lower sensitivity. AED manufacturers should work to improve the algorithms. In addition, AED use should always be reviewed with a routine for giving feedback, and medical personnel should be aware of the specific strengths and shortcomings of the device they are using. (C) 2017 Elsevier B.V. All rights reserved.

  • 9.
    Israelsson, Johan
    et al.
    Kalmar County Hospital, Sweden.
    von Wangenheim, Burkard
    Kalmar County Hospital, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Semark, Birgitta
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Jörg
    Kalmar County Hospital, Sweden.
    Sensitivity and specificity of two different automated external defibrillators used in-hospital and out-of-hospital2015In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 96, no Supplement 1, p. 23-23, article id AS041Article in journal (Other academic)
    Abstract [en]

    Purpose: To investigate the performance of two different types of automated external defibrillators (AED) in out-of-hospital and in-hospital cardiac pulmonary resuscitation (CPR). Performance criteria in terms of sensitivity and specificity have been established but real life data are sparse.

    Materials and methods: Three investigators reviewed 2938 rhythm analyses performed by AED in 240 consecutive patients (38.3% women) suffering cardiac arrest between January 2011 and March 2015. The mean age was 70.1 ± 17.0 (3 months–104 years). Two different AED were used (AED A n = 105, AED B n = 135) in-hospital (n = 91) and out-of-hospital (n = 149).

    Results: Among 194 shockable rhythms, 17 (8.8%) were not recognized by AED A, while AED B recognized 100% (n = 135) of shockable episodes (p < 0.001). In AED A, 8 (47.1%) of these episodes were judged to be algorithm errors while 9 (52.9%) were caused by external artifacts. Among 1039 non-shockable rhythms, AED A recommended shock in 11 (1.0%), while AED B recommended shock in 63 (4.1%) of 1523 episodes (p < 0.001). In AED A, 2 (18.2%) of these episodes were judged to be algorithm errors (AED B, n = 40, 63.5%) while 9 (81.8%) were caused by external artifacts (AED B, n = 23, 36.5%). Fine ventricular fibrillation was analyzed as a separate category since guidelines do not recommend shock in these cases. AED A advised shock in 24 (80%) of 30 episodes, while AED B advised shock in 8 (47%) of 17 episodes (p < 0.027).

    Conclusions: Significant differences in performance could be detected between two different AED. A higher sensitivity of AED B was associated with a lower specificity while a higher specificity of AED A was associated with a lower sensitivity. Caregivers should be aware of the specific shortcomings of the device they are using. AED manufacturers should try to improve the algorithms in order to minimize the gap between sensitivity and specificity.

  • 10.
    Nordström, Erik Blennow
    et al.
    Lund University.
    Lilja, Gisela
    Lund University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital.
    Friberg, Hans
    Lund University.
    Nielsen, Niklas
    Lund University.
    Vestberg, Susanna
    Lund University.
    Cronberg, Tobias
    Lund University.
    Validity of the IQCODE-CA: An informant questionnaire on cognitive decline modified for a cardiac arrest population2017In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 118, p. 8-14Article in journal (Refereed)
    Abstract [en]

    Aim: To examine the psychometric properties of a modified version of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), for a cardiac arrest population (IQCODE-CA). Methods: The IQCODE-CA, a 26-item observer-reported questionnaire, was completed by informants, defined as relatives or close friends, of 268 out-of-hospital cardiac arrest (OHCA) survivors who participated in the Target Temperature Management trial in a scheduled follow-up 180 +/- 14 days after OHCA. Survivors completed the Mini Mental State Examination (MMSE), the Rivermead Behavioural Memory Test (RBMT) and the Hospital Anxiety and Depression Scale (HADS). An exploratory factor analysis was performed. Associations between IQCODE-CA results and demographic variables along with other instruments were calculated. Area under the curve (AUC) ratios were evaluated to examine discrimination. Results: The IQCODE-CA measured one factor, global cognitive decline, with high internal consistency (ordinal alpha = 0.95). Age, gender or education did not influence the IQCODE-CA score. Associations with performance-based measures of global cognitive function as well as anxiety and depression ranged from small to moderate (rs = -0.29 to 0.38). AUC ratios ranged from fair to good (0.72-0.81). According to the MMSE and RBMT, the optimal cut-off score to identify cognitive decline on the IQCODE-CA was 3.04. Using this value, 53% of the survivors were under the cut-off. Conclusions: The IQCODE-CA identified a large amount of survivors with possible cognitive problems, making it useful when screening for cognitive decline post-CA. Due to lower AUC ratios than desired, additional performance-based measures should be used to improve the overall screening methodology. (C) 2017 Elsevier B.V. All rights reserved.

  • 11.
    Semark, Birgitta
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Kalmar County Hospital.
    Carlsson, Jörg
    Kalmar County Hospital.
    von Wangenheim, Burkard
    Kalmar County Hospital.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Quality of chest compressions during CPR-comparison between manual and automatic review2015In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 96, no Supplement 1, p. 66-66, article id AP058Article in journal (Refereed)
  • 12.
    Steel, Karin
    et al.
    Linköping University.
    Bremer, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council.
    Gunnarsson, Lise-Lotte
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council.
    Strömberg, Anna
    Linköping University.
    Hjelm, Carina
    Linköping University.
    Nurses’ perceptions of cognitive function in survivors after cardiac arrest: a qualitative study2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, p. e128-e128Article in journal (Refereed)
  • 13.
    Årestedt, Kristofer
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    Allert, Camilla
    Blekinge Institute of Technology, Sweden.
    Djukanovic, Ingrid
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Council, Sweden.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Agerström, Jens
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Herlitz, Johan
    University of Borås, Sweden.
    Årestedt, Liselott
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bremer, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    Health-related quality of life among in-hospital cardiac arrest survivors in working age2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, article id e18Article in journal (Refereed)
  • 14.
    Årestedt, Kristofer
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Kalmar County Hospital, Sweden.
    Herlitz, Johan
    University of Borås, Sweden.
    Bremer, Anders
    University of Borås, Sweden.
    Psychometric properties of the Hospital Anxiety and Depressionscale in sudden cardiac arrest survivors2015In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 96, no Suppl 1, p. 141-141Article in journal (Refereed)
    Abstract [en]

    Purpose: Emotional distress, in terms of anxiety and depression, is common among patients who survive a sudden cardiac arrest (SCA). The Hospital Anxiety and Depression scale (HAD) is one of the most used instruments to assess emotional distress in SCA survivors. However, it has not to our knowledge been psychometrically tested in this group of patients. The aim was therefore to evaluate the measurement properties of the HAD in SCA survivors.

    Materials and methods: Data from the Swedish Register of Cardiopulmonary Resuscitation was used. In the register, data is collected 3–6 months after resuscitation by using a questionnaire including HAD. Data quality was evaluated according to the distribution of item and scale score and missing data patterns. A principal component factor analysis was conducted to explore the factor structure. Internal consistency was evaluated with Cronbach's alpha.

    Results: The sample consisted of 498 in-hospital survivors with a mean age of 69.3 ± 12.6 years. All items demonstrated problems with floor effects. The scale scores for both anxiety and depression deviated significantly from a normal distribution (p < 0.001). The factor analysis reproduced the hypothesized two-factor structure, which explained 59% of the total variance. The factor loadings varied between 0.547 and 0.778 for anxiety and between 0.651 and 0.780 for depression. Cronbach's alpha was 0.874 and 0.875 for anxiety and depression respectively.

    Conclusions: The HAD demonstrated good measurement properties among SCA survivors. Despite problems with floor effects, the two HAD scales, anxiety and depression, seem to be uni-dimensional measures with good internal consistency. Therefore, the HAD can be recommended to assess emotional distress among SCA survivors.

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