Influence of summer tourist flows on occurrence of out-of-hospital cardiac arrest in an Italian tourist-intensive area.

INTRODUCTION: The study aims to evaluate the seasonal variation of out-of hospital cardiac arrest (OHCA) in a tourist-intensive area. METHODS: Data of all OHCA treated by the Emergency Medical Service of Lecce (LE-EMS), Italy, between 2013 and 2017, were retrospectively analyzed and complemented with information about tourist flows, in order to determine the influence of the seasonal variation of population on incidence and outcome. RESULTS: Tourist arrivals were around 1,700,000 per year, mostly in summer, adding up to 803,161 residents. The occurrence of OHCA did not show a monthly variation when referring to the resident population (p = 0.90). When taking into account the tourist flows, a difference in occurrence of OHCA across months was found, with the highest rate of arrests in December and the lowest in August (10.3 vs 3.4 per 100,000 persons, p < 0.01). No difference was found in terms of EMS arrival time and event survival rate between summer and the rest of the year (13.6 vs 13.8 min, p = 0.55, and 4.4% vs 4.5%, p = 0.86, respectively). CONCLUSION: In summer tourism areas, the occurrence of OHCA is unchanged throughout the year, while the actual population presents seasonal increases. Summer enhancement of provincial EMS may contribute to maintain the performance of emergency care.

Floating thrombus in the thoracic aorta: what should be done?

Floating thrombus in a non-aneurysmal and non-atherosclerotic thoracic aorta is a rare event with potentially catastrophic complications. Especially younger patients have a higher risk of embolization. Transesophageal echocardiography is the diagnostic method of choice. However, the treatment of this pathology is still controversial and includes both medical and surgical options. We report our experience with a 43-year-old patient and a review of the literature, and make a proposal for therapeutic interventions.