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Sudden cardiac arrests are more likely to happen on any day at any time : Study

Raghu Kshitiz

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A new study has showed that sudden cardiac arrests are more likely to happen on any day at any time, challenging previous claims that weekday mornings — especially Mondays — were the danger zones.

Previously heart experts have long believed that weekday mornings were the danger zones for unexpected deaths from sudden cardiac arrests.

“While there are likely several reasons to explain why more cardiac arrests happen outside of previously identified peak times, stress is likely a major factor,” said Sumeet Chugh, a Professor of medicine from the Smidt Heart Institute in the US.

“We now live in a fast-paced, ‘always on’ era that causes increased psycho-social stress and possibly an increase in the likelihood of sudden cardiac arrest,” Chugh added.

Almost 17 million cardiac deaths occur annually worldwide while the survival rate from sudden cardiac arrest is less than one per cent.

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For the study, published in the journal Heart Rhythm, Chugh’s team analysed data on 1,535 from the community-based Oregon Sudden Unexpected Death Study between 2004 to 2014, among which only 13.9 per cent died in the early morning hours, the findings revealed.

All reported cases were based on emergency medical service reports containing detailed information regarding the cause of the cardiac arrest.

“Because sudden cardiac arrest is usually fatal, we have to prevent it before it strikes,” Chugh said. “Our next steps are to conclusively determine the underlying reasons behind this shift, then identify public health implications as a result,” he added.

Apart from stress, other contributing factors may be a shift in how high-risk patients are being treated, as well as inadequacies in how past studies have measured time of death caused by sudden cardiac arrest.

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Suicide can’t be predicted by asking about suicidal thoughts : Study

Gorkha Post

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Most people who died of suicide deny they experience suicidal thoughts when asked by doctors in the weeks and months leading up to their death, a major Australian study has found.

The findings, co-authored by clinical psychiatrist and Professor Matthew Large from UNSW’s School of Psychiatry, Sydney that published in the journal BJPsych Open The meta-analysis challenge the widely-held assumption that psychiatrists can predict who will suicide by asking if they are preoccupied with thoughts of killing themselves.

The study showed that 80% of patients who were not undergoing psychiatric treatment and who died of suicide reported not to have suicidal thoughts when asked by their psychiatrist or GP.

“If you meet someone who has suicidal ideation there is a 98 per cent chance that they are not going to suicide,” said Professor Large, an international expert on suicide risk assessment who also works in the emergency department of a major Sydney hospital.

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“But what we didn’t know was how frequently people who go on to suicide have denied having suicidal thoughts when asked directly,” he added.

“This study proves we can no longer ration psychiatric care based on the presence of suicidal thoughts alone. We need to provide high-quality, patient-centred care for everyone experiencing mental illness, whether or not they reveal they are experiencing suicidal thoughts,” Professor Large said.

About one in 10 people will have suicidal ideation in their lifetime. But the study showed suicidal ideation alone was not rational grounds for deciding who gets treatment and who does not, Professor Large said.

“We know that suicide feeling is pretty common and that suicide is actually a rare event, even among people with severe mental illness,” Professor Large added.

Suicidal ideation tells us an awful lot about how a person is feeling, their psychological distress, sometimes their diagnosis and their need for treatment but it’s not a meaningful test of future behaviour.

Suicidal feelings can fluctuate rapidly and people may suicide very impulsively after only a short period of suicidal thoughts.

But, people had good reasons not to disclose thoughts of suicide, fearing stigma, triggering over-reactions or upsetting family and friends, and being involuntarily admitted for psychiatric treatment, Professor Large said.

Professor Large emphasized that clinicians should not assume that patients experiencing mental distress without reporting suicidal ideas were not at elevated risk of suicide.

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