DOCSLIB.ORG

Prevalence and In-Hospital Outcome of Aspiration in Out-Of-Hospital Intubated Trauma Patients

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Prevalence and In-Hospital Outcome of Aspiration in Out-Of-Hospital Intubated Trauma Patients Zurich Open Repository and Archive University of Zurich Main Library Strickhofstrasse 39 CH-8057 Zurich www.zora.uzh.ch Year: 2017 Prevalence and in-hospital outcome of aspiration in out-of-hospital intubated trauma patients Radu, Raluca R DOI: https://doi.org/10.1097/MEJ.0000000000000465 Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-143920 Dissertation Published Version Originally published at: Radu, Raluca R. Prevalence and in-hospital outcome of aspiration in out-of-hospital intubated trauma patients. 2017, University of Zurich, Faculty of Medicine. DOI: https://doi.org/10.1097/MEJ.0000000000000465 Zurich Open Repository and Archive University of Zurich Main Library Strickhofstrasse 39 CH-8057 Zurich www.zora.uzh.ch Year: 2017 Prevalence and in-hospital outcome of aspiration in out-of-hospital intubated trauma patients Radu, Raluca R; Kaserer, Alexander; Seifert, Burkhardt; Simmen, Hans-Peter; Ruetzler, Kurt; Spahn, Donat R; Neuhaus, Valentin DOI: https://doi.org/10.1097/MEJ.0000000000000465 Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-136821 Veröffentlichte Version Originally published at: Radu, Raluca R; Kaserer, Alexander; Seifert, Burkhardt; Simmen, Hans-Peter; Ruetzler, Kurt; Spahn, Donat R; Neuhaus, Valentin (2017). Prevalence and in-hospital outcome of aspiration in out-of-hospital intubated trauma patients. European Journal of Emergency Medicine:Epub ahead of print. DOI: https://doi.org/10.1097/MEJ.0000000000000465 Original article 1 Prevalence and in-hospital outcome of aspiration in out-of-hospital intubated trauma patients Raluca R. Radua,*, Alexander Kaserera,*, Burkhardt Seifertc, Hans-Peter Simmenb, Kurt Ruetzlera,d, Donat R. Spahna and Valentin Neuhausb Objective The aim of this study was to evaluate the Injury Severity Score, and older age were independent prevalence for aspiration in out-of-hospital intubated predictors of 30-day mortality, but not aspiration. trauma patients and its impact on the in-hospital outcome. Conclusion Aspiration was frequent in out-of-hospital Patients and methods Medical records of out-of-hospital intubated trauma patients and was associated with higher intubated trauma patients, admitted from 2009 to 2014 to a mortality and less favorable outcome, but was not an level 1 trauma center, were retrospectively reviewed. independent predictor of mortality and morbidity. However, Patients younger than 18 years, treated with a supraglottic a low initial GCS on scene was shown to be an independent airway device, without a thorax computed tomography at predictor for aspiration and mortality. European Journal of admission, and with lung contusions were excluded. Two Emergency Medicine 00:000–000 Copyright © Wolters hundred and eighty-one patients were further analyzed. The Kluwer Health, Inc. All rights reserved. definition of aspiration was based on computer European Journal of Emergency Medicine 2017, 00:000–000 tomographic findings at admission. Variables were analyzed in multivariate logistic and Cox regression analyses. Keywords: aspiration, intubation, outcome, out-of-hospital, prevalence, trauma Results Aspiration occurred in 90 (32%) patients. The aInstitute of Anesthesiology, bDepartment of Surgery, Division of Trauma Surgery, mean Injury Severity Score was significantly higher in the University Hospital Zurich, cDivision of Biostatistics at Epidemiology, Biostatistics = and Prevention Institute, University of Zurich, Zurich, Switzerland and aspiration group (40 ± 26 vs. 33 ± 22, P 0.032), whereas the dDepartments of Outcome Research and General Anesthesiology, mean initial Glasgow Coma Scale (GCS) on scene was Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, USA < significantly lower (5 ± 3 vs. 7 ± 4, P 0.001). In multivariate Correspondence to Valentin Neuhaus, MD, PD, Department of Surgery, Division of analysis, a lower initial GCS was a significant predictor for Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland Tel: + 41 44 255 11 11; fax: + 41 44 255 44 06; aspiration. Pneumonia, systemic inflammatory response e-mail: [email protected] syndrome, and sepsis occurred at similar frequencies. The = *Raluca R. Radu and Alexander Kaserer contributed equally to the writing of this 1-day (41 vs. 23%, P 0.003) and the 30-day mortality (53 vs. article. 34%, P = 0.003) were significantly higher in the aspiration group. In survival analysis, a lower initial GCS, a higher Received 14 November 2016 Accepted 6 March 2017 Introduction limited and the reported incidence ranges between 34 Early intubation on scene in trauma patients is indicated and 50% [6,7,10–12]. according to international trauma guidelines including Possible complications after aspiration are airway PHTLS, ATLS or ETC. Especially patients with trau- obstruction, Mendelson’s syndrome, pneumonia, or acute matic head injury or shock benefit from early intubation – respiratory distress syndrome (ARDS), which are asso- and controlled ventilation [1 3]. Furthermore, intubation ciated with prolonged ventilator weaning, ICU stay, and prevents pulmonary aspiration [4,5]. However, urgent increased mortality [12–14]. intubation per se is also associated with an increased risk of aspiration [6,7]. Trauma patients are often not fasted; The aim of this study was to evaluate the prevalence and blood, vomitus, or swelling may make it difficult to to investigate the impact of aspiration on in-hospital visualize the larynx and vocal cords. In addition, difficult outcome for out-of-hospital intubated trauma patients airway situations (face and neck trauma; constrained in a level 1 trauma center in Switzerland. mouth opening; cervical spine immobilization), low Glasgow Coma Scale (GCS), obesity, difficult environ- mental conditions (poor light; limited space), as well as Patients and methods inexperienced physicians can increase the risk of aspira- In a retrospective study, all inpatient medical records tion [8]. Previous studies have reported incidences from a level 1 trauma center in Switzerland between 2009 and 2014 were reviewed. The local ethical committee between 1 and 20% among various patient groups approved the study (KEK-ZH-No: 2011-0382). requiring emergent airway management in either the emergency department or the ICU [6,9]. In contrast, data In Switzerland, prehospital care in case of severely on pulmonary aspiration in the out-of-hospital setting are injured patients is usually provided by a medical doctor 0969-9546 Copyright © Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/MEJ.0000000000000465 Copyright r 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. 2 European Journal of Emergency Medicine 2017, Vol 00 No 00 (in our area usually an anesthesia resident) and a para- to compare aspiration, patient, and injury factors asso- medic team. Severely injured patients are transferred by ciated with mortality. Adjusted odds ratio with corre- ambulance or helicopter to one of 12 trauma centers. In sponding 95% confidence interval (CI) were tabulated. our trauma center, a standardized clinical approach is Statistical significance was set as a two-tailed P-value of provided in the resuscitation area, where severely injured less than 0.05. To answer the question of whether patients are usually admitted first. The standard approach aspiration is an independent risk factor for a negative in- consists of a primary survey and further treatment hospital outcome, time to mortality, time to death or according to ATLS or ETC is applied by the trauma staff complications, and time to extubation were included in including at least one senior and one junior anesthetist, survival Kaplan–Meier curves and compared with the one senior, and one junior trauma surgeon as well as log-rank Mantel–Cox test as well as in Cox regression several nurses. The whole-body computed tomography analyses while controlling for aspiration, age, sex, ISS, (CT) scan is considered the gold standard and is per- GCS, and comorbidities. Two variables (liver failure and formed in all major trauma patients as soon as possible to gastroesophageal reflux disease ) were excluded from the evaluate their relevant injuries and determine further multivariate analyses as they were always associated with treatment. one of the possible outcomes. All statistical analyses were All trauma patients who underwent out-of-hospital intu- carried out by IBM SPSS Statistics 22 (SPSS Inc., bation during the defined study period were included Chicago, Illinois, USA). (n = 434). Exclusion criteria were age younger than 18 years, supraglottic airway devices, no chest CT scan at admission, and lung contusions because of the difficulties in distinguishing contusions and aspiration on chest CT Results scan. A total of 281 trauma patients fulfilled the inclusion Demographics, prevalence of aspiration, and risk factors and exclusion criteria, were further analyzed, and divided for aspiration into an aspiration group and a no-aspiration group. Junior Ninety out of 281 (32%) of our trauma patients admitted and senior radiologists on call reviewed the CT scans. to our hospital had radiologic findings associated with Classic radiographic findings in acute aspiration included pulmonary aspiration. Demographics such as age, sex, ground glass opacity; perihilar, ill-defined, alveolar con- and source of admission were the same in both groups solidations; multifocal patchy
Load more

Recommended publications
  • Lake Zürich Lake Cruises from Zürich
    Lake Zürich Lake Cruises Zürich Bürkliplatz from Zürich Zürich Wollishofen Zürichhorn Casino Zollikon 3 April – 23 October 2011 Kilchberg Bendlikon Rüschlikon Küsnacht Thalwil Küsnacht Heslibach Oberrieden Erlenbach Herrliberg Horgen Meilen Halbinsel Au Uetikon Wädenswil Männedorf Stäfa Richterswil Uerikon Insel Ufenau Pfäffikon SZ Rapperswil Altendorf Lachen Schmerikon L Morning Round Trips 2 h Fares and information Z Zürich Bürkliplatz 09.00 Zürich Bürkliplatz 10.00 Adult Child (aged 6 –16) ZVV zones Zürichhorn Casino 09.14 Zürich Wollishofen 10.14 1/2-Fare Card, Dogs required Zollikon 09.21 Kilchberg Bendlikon 10.25 Upper Lake and 1. Cl. CHF 52.00 1. Cl. CHF 26.00 Küsnacht 09.30 Rüschlikon 10.31 Long Round Trip All zones at 08.30 am 2. Cl. CHF 31.60 2. Cl. CHF 15.80 Küsnacht Heslibach 09.36 Thalwil 10.40 Up. Lake Round Erlenbach 09.40 Erlenbach 10.47 1. Cl. CHF 40.00 1. Cl. CHF 20.00 Trip at 11.30 am/ All zones Thalwil 09.50 Küsnacht Heslibach 10.50 Long Round (9 O'ClockPass) Küsnacht 10.00 Küsnacht 11.00 2. Cl. CHF 24.00 2. Cl. CHF 12.00 Trips from 9.30 am Küsnacht Heslibach 10.06 Küsnacht Heslibach 11.06 with change in Richterswil resp. Stäfa 10, 40, 41, 42, 43 Erlenbach 10.10 Erlenbach 11.10 1. Cl. CHF 38.80 1. Cl. CHF 19.40 or Thalwil 10.20 Thalwil 11.20 Medium 2. Cl. CHF 23.60 2. Cl. CHF 11.80 10, 50, 51, 52, 53 Küsnacht 10.30 Rüschlikon 11.27 Round Trips with change in Männedorf 10, 40, 41, 42 Zollikon 10.38 Kilchberg Bendlikon 11.33 1.
    [Show full text]
  • Thalwil–Horgen Oberdorf: Spezialfahrplan Wegen Gleisarbeiten
    Thalwil–Horgen Oberdorf: Spezialfahrplan wegen Gleisarbeiten Zwischen Thalwil und Horgen Oberdorf gilt während zwölf Tagen ein Spezialfahrplan im Regional- und Fernverkehr. Grund: Es werden Gleisarbeiten ausgeführt für weiterhin pünktliche und sichere Züge. Text: Jasmin Huwyler | Fotos: SBB/CFF/FFS Weitere Artikel: www.news.sbb.ch 1/3 Die SBB unterhält eines der meistbefahrenen Bahnnetze der Welt. Damit die Züge auch weiterhin pünktlich und sicher fahren können, muss das intensiv genutzte Netz entsprechend gepflegt werden. Aus diesem Grund erneuert die SBB auf der Strecke Thalwil–Horgen Oberdorf Schienen, Schwellen und Schotter und führt gleichzeitig Felsarbeiten aus. Während des folgenden Zeitraums gilt ein Spezialfahrplan: Montag, 13. Mai, ab 21.30 Uhr, durchgehend bis Donnerstag, 23. Mai, um 5.30 Uhr. Nächte von Donnerstag/Freitag, 23./24. Mai und Sonntag/Montag, 26./27. Mai, jeweils von 21.30 bis 5.30 Uhr. Der Spezialfahrplan gilt für die folgenden Verbindungen im Regional- und Fernverkehr: S24 (Schaffhausen / Weinfelden–Zürich Flughafen–Thalwil–Horgen Oberdorf–Zug): Im Abschnitt zwischen Thalwil–Oberrieden Dorf– Horgen Oberdorf fahren in beide Richtungen Bahnersatzbusse. S24: Im Abschnitt zwischen Horgen Oberdorf–Baar–Zug verkehren die Züge, allerdings mit teilweise geänderten Abfahrtszeiten. IC (Zürich HB–Thalwil–Zug–Lugano): Diese Züge verkehren zwischen Zürich HB und Zug mit geänderten Abfahrts- oder die Ankunftszeiten. Die Reisezeit verlängert sich je nach Reiseweg um bis zu 15 Minuten. Reisende werden gebeten, ihre Verbindung in der SBB Mobile App oder im Online-Fahrplan auf www.sbb.ch zu prüfen. Bei Fragen hilft der Rail Service 0848 44 66 88 (CHF 0.08/Min.) weiter. Mehr Informationen: www.sbb.ch/zuerich > Streckenunterbrüche Weitere Artikel: www.news.sbb.ch 2/3 Informationen für Reisende mit eingeschränkter Mobilität Reisende im Rollstuhl oder mit anderweitig eingeschränkter Mobilität (Kinderwagen, viel Reisegepäck, usw.) können in Horgen Oberdorf wegen der Bauarbeiten nicht umsteigen.
    [Show full text]
  • Projekt "Kbs See", Schlussbericht, AWEL, Juli 2019
    Kanton Zürich Baudirektion Ent- Amt für wurf Abfall, Wasser, Energie und Luft Abfallwirtschaft und Betriebe / Gewässerschutz / Wasserbau 1. No- vem- Altlasten ber 2016 Projekt «KbS Seen» Erfassung belasteter Standorte in den Seen des Kantons Zürich Schlussbericht Juli 2019 Projekt «KbS Seen» - Schlussbericht Baudirektion Inhalt 2/15 Das Wichtigste in Kürze ................................................................................................. 3 1. Ausgangslage und Ziele des Projektes .............................................................. 4 1.1 Bisherige Kenntnisse über Belastungen in den Seen ........................................ 4 1.2 Projektstart «KbS Seen» und Ziele .................................................................... 4 2. Vorgängige Abklärungen zu Belastungen im See und deren Bewertung .......... 4 2.1 Untersuchungsmethoden für Seesedimente ...................................................... 4 2.2 Bestimmung der Hintergrundbelastung und Festlegung der Hintergrundwerte 5 2.3 Kriterien für den Eintrag in den Kataster ............................................................ 5 2.4 Abschätzung der Gefährdung ............................................................................. 6 3. Systematische Untersuchungen der Seesedimente .......................................... 7 3.1 Grundraster ......................................................................................................... 7 3.2 Verdichtung des Grundrasters ...........................................................................
    [Show full text]
  • Your Way to the Centre
    Your way to the Centre How to find us: By Swiss Re Shuttle Bus By Train From Chur: take motorway A3 in Swiss Re Shuttle Service (maximum The most convenient station for the the direction of Zurich ➞ leave the 15 persons). The buses leave at Centre is Thalwil. There are several motorway at the Thalwil exit ➞ and set times from Swiss Re Mythenquai regular rail connections from the leave the 1st and 2nd roundabout (travel time 15 minutes) and from Airport and from Zurich Central Sta- in the direction of Rüschlikon ➞ Soodring 33 at Adliswil (travel time tion to Thalwil. Travel time: Airport- 3rd roundabout turn right in the 10 minutes). A detailed timetable Thalwil: about 30 minutes, Central direction of “Dorfzentrum” ➞ after is available upon request. Station-Thalwil: about 15 minutes. about 200 m turn left (“Swiss Re From Thalwil station take a taxi to Rüschlikon” signpost) ➞ after about By Bus our Centre, travel time about 400 m you will find the “Swiss Re Bus 165: take the bus at Zurich 10 minutes. The train timetable Centre for Global Dialogue” on your Bürkliplatz in the direction of can be found in the Internet at right. Rüschlikon to the “Säumerstrasse” www.sbb.ch. stop. The centre is a 5 minute walk By Taxi (see map overleaf). By Car You can reach our Centre by taxi From Zurich: take motorway A3 in from the Airport in about 45 min- The Swiss Re Centre for Global Bus 161: take the bus at Zurich the direction of Chur ➞ leave the utes, from Zurich Central Station in Dialogue is located in Rüschlikon Bürkliplatz in the direction of Kilch- motorway at the Thalwil exit ➞ and about 30 minutes and from Thalwil above Lake Zurich.
    [Show full text]
  • Celebrate the Spirit of Street Parade!
    Nacht-S-Bahnen ab Winterthur Verkehrsbetriebe der Region So gehts an die Parade – Fahrpläne und wieder zurück Nachtangebot Ab 1 Uhr ZVV-Nachtzuschlag erforderlich. Street Parade Alle Linien haben direkten Anschluss an die S-Bahn Direkt und schnell: S-Bahn, Tram und Bus (Alphabetisch ansteigend nach Umsteigebahnhöfen). bringen jede Raverin und jeden Raver dahin, Damit du da bist, wo dein Takt ist. wo die Party ist. Und sicher wieder nach Hause. Zürich – Triemli – Uitikon Waldegg – Uetliberg (SZU) S10 Winterthur – Andelfingen – Schaffhausen – Stein am Rhein SN3 UMSTEIGE- ZVV- VON BETRIEB NACH ABFAHRTSZEITEN UMSTEIGE- ZVV- VON BETRIEB NACH ABFAHRTSZEITEN Halt an allen Stationen. Zürich HB ab 0 18 1 00 2 00 3 00 4 00 BAHNHOF LINIE BAHNHOF LINIE Fahrpläne S10 S10 S10 S10 S10 S10 Winterthur an 0 39 1 24 2 24 3 24 4 24 Affoltern a. A. N24 SN9 PostAuto Aeugst-Hausen-Ebertswil-Kappel-Hauptikon- 2 33 4 33 Stettbach 743 SN5 VBZ Fällanden, Wigarten° 1 16 alle 30 Min. bis 4 16 Alle Fahrpläne finden Sie unter www.zvv.ch. Zürich HB ab 23 55 0 251 1 05 2 05 3 05 4 052 SN3 SN3 SN3 SN3 Rifferswil (-Knonau) 751 SN5 VBZ Kirche Fluntern° 0 45 alle 60 Min. bis 3 45 1 2 Zusätzlich finden Sie die besten Nachtver- Zürich Triemli an 0 03 0 33 1 13 2 13 3 13 4 13 Winterthur ab 0 44 1 27 2 27 3 27 4 27 N25 SN9 PostAuto Mettmenstetten-Knonau-Hausen-Aeugst 1 33 3 33 752 SN5 VBZ Dübendorf, Kunsteisbahn° 1 16 alle 60 Min.
    [Show full text]
  • Ziegelbrücke Zürich - Thalwil - Zug Stand: 17
    FAHRPLANJAHR 2020 720 Zürich - Thalwil - Ziegelbrücke Zürich - Thalwil - Zug Stand: 17. Oktober 2019 S8 S8 S24 75 S27 S8 S24 70 18817 18817 20417 2104 8219 18819 20419 2611 SBB SBB SBB SBB SOB SBB SBB SBB Winterthur Winterthur Zürich Flughafen ab 5 00 5 34 Zürich HB 5 07 5 07 5 21 5 35 5 37 5 51 6 04 Zürich Wiedikon 5 09 5 09 5 24 5 39 5 54 Zürich Enge 5 12 5 12 5 27 5 42 5 57 Zürich Wollishofen 5 14 5 14 5 29 5 44 5 59 Kilchberg 5 17 5 17 5 32 5 47 6 02 Rüschlikon 5 20 5 20 5 35 5 50 6 05 Thalwil 5 23 5 23 5 37 5 44 5 53 6 07 6 13 Thalwil 5 24 5 24 5 38 5 45 5 54 6 08 6 14 Oberrieden Dorf 5 40 6 10 Horgen Oberdorf 5 43 6 13 Baar 5 51 5 58 6 21 Zug 5 54 6 01 6 24 6 27 Oberrieden 5 26 5 26 5 56 Horgen 5 30 5 30 6 00 Au ZH 5 33 5 33 6 03 Wädenswil 5 37 5 37 6 07 Richterswil 5 40 5 40 6 10 Bäch 5 42 5 42 6 12 Freienbach SBB 5 45 5 45 6 15 Pfäffikon SZ 5 49 5 49 6 19 Pfäffikon SZ 6 29 Altendorf 6 32 Lachen 6 34 Siebnen-Wangen 6 09 6 39 Schübelbach-Buttikon 6 11 6 41 Reichenburg 6 14 6 44 Bilten 6 17 6 47 Ziegelbrücke 6 22 6 53 Rapperswil Luzern Luzern 1 / 64 FAHRPLANJAHR 2020 720 Zürich - Thalwil - Ziegelbrücke Zürich - Thalwil - Zug Stand: 17.
    [Show full text]
  • Alpen Challenge 2021, Lenzerheide Zeit: 15:37:19 Seite: 1
    Datum: 13.06.21 Alpen Challenge 2021, Lenzerheide Zeit: 15:37:19 Seite: 1 (3) Classic Herren Grand Masters Rang Name Jg Land Ort Team Zeit Abstand Overall Stnr 1. Rose Markus 1971 Oetwil am See RTU RennveloTeamUster 3:57.53,5 ------ 117-Men 21. 163 2. Bruggmann Michael 1969 Thalwil Bruggmann 3:59.26,8 1.33,3 117-Men 26. 61 3. Schwitter Josef 1970 Näfels Central-Garage Glarus 4:02.02,9 4.09,4 117-Men 35. 162 4. Künzle Felix 1967 Weisslingen RTU RennveloTeamUster 4:03.12,9 5.19,4 117-Men 39. 172 5. Baumberger Willi 1965 Thusis Campell 4:03.15,0 5.21,5 117-Men 40. 176 6. Nenniger Christoph 1970 Brünisried Tempo-Sport BE THE CHANGE 4:07.03,4 9.09,9 117-Men 58. 91 7. Schmid Cornel 1969 Küssnacht am Rigi Velo Scheidegger 4:17.28,3 19.34,8 117-Men 93. 253 8. Paganini Moreno 1970 Celerina/Schlarigna Finsks 4:18.42,5 20.49,0 117-Men 99. 47 9. Pollak Wolfgang 1968 Pontresina STD Racing Team 4:19.56,6 22.03,1 117-Men 106. 194 10. Strasser Markus 1965 Ebnat-Kappel 4:20.26,3 22.32,8 117-Men 109. 769 11. Siragusano Carmelo 1971 Uster Band of Brothers 4:21.04,4 23.10,9 117-Men 113. 967 12. Wetli Maico 1963 Walenstadt Gümmeler 4:21.40,8 23.47,3 117-Men 114. 287 13. Nicca Paul 1970 Donat RMV Chur 4:22.56,4 25.02,9 117-Men 117.
    [Show full text]
  • The Phenomenon of Googlewil Where and How Do Swiss and Foreigners Live in Zurich?
    Abschlussarbeit zur Erlangung des Master of Advanced Studies in Real Estate The Phenomenon of Googlewil Where and how do Swiss and foreigners live in Zurich? Study of location choices of IT employees within Zurich area Verfasserin: KURANT Marta Adresse Hofackerstrasse 29, 8032 Zürich Mail [email protected] Telefon +41 76 427 90 42 Eingereicht bei: Mihnea Constantinescu Abgabedatum: 29.08.2016 I Table of contents List of abbreviations……………...……….…………..………………….............. III List of figures………………….………...………….…….…......….……………. IV List of tables…………….……………...………….……….…….….……………. V Abstract……………………………………...….………….……………………….VI 1. Introduction..…………………………………………..………........................... 1 1.1. Research objectives ..………………..….................................................. 1 1.2. Narrowing of the research area....……………..…….…………………….. 1 1.3. Importance of the study……………….……………..……………………... 3 1.4. Research design……………………………………………………………. 3 2. Theoretical background………………………………………………………….. 4 2.1. Definition of Terms……………………………….………………………... 4 2.2. General picture of immigration into Switzerland and Zurich….…………... 4 2.2.1. Immigration into Switzerland…………………………………………... 4 2.2.2. Immigration into the Zurich area………………………………………...6 2.2.3. Popular opinion…………………………………………………............. 7 2.2.4. Immigration effects on the real estate market…………………………. 8 2.3. State of the art………………………………………………………...……. 9 2.3.1. Location choices of households………………………………............... 9 2.3.2. Rent vs. ownership……………………………………………..……... 11 2.3.3. Taxes
    [Show full text]
  • 93. Jahresbericht 2019
    Deckblatt Jahresbericht ZSL Zürichsee Landschaftsschutz ZSL 93.Jahresbericht 2019 Einladung zur 93. Generalversammlung auf Samstag, den 27. Juni 2020, 1400 Uhr im Schlossturm in Pfäffikon/SZ Inhalt Seite Einladung zur 93. Generalversammlung 3 Jahresbericht 2019 4 Unser Projekt, Stand Februar 2020 5 Linkes Zürichseeufer 6 Steinfabrikareal Pfäffikon 9 Seeuferplanung Thalwil 10 Koko, biologische Hotspots 14 Rechtes Zürichseeufer 16 Uetikon a/See 18 Medienmitteilung, Roger Federer 21 Brief an Baudirektion 22 Antwort der Baurektion 24 Bilanz 26 Betriebsrechnung 27 Separat Fonds 28 Revisionbericht 29 Vorstand und Revisoren 30 Unser Verein ist steuerbefreit; Ihre Zuwendungen sind im Rahmen der gesetzlichen Vorschriften bei der Einkommenssteuer abzugsberechtigt. Zürcher Kantonalbank, Zürich IBAN CH39 0070 0110 0066 5100 5 Lautend auf: Zürichsee Landschaftsschutz ZSL Alle Artikel, die nicht speziell gekennzeichnet sind, stammen aus der Feder von Vorstandsmitgliedern. 2 Einladung zur 93. Generalversammlung Datum / Zeit Samstag, den 27. Juni 2020, 1400 – 1630 Uhr Ort / Raum Schlossturm in Pfäffikon/SZ Erreichbar mit dem OeV ab Zürich HB mit der S8 (mit Halt an allen Stationen); S2; S25 (nach Linthal); RE (nach Chur); ab Rapperswil-Jona S5; SOB S40 (nach Einsiedeln); SOB IR Voralpen Express (nach Luzern); ab Ziegelbrücke: RE (von Chur, nach Zürich HB); S2; S25 (von Linthal nach Zürich HB) Im Schlossturm können im Saal über 100 Gäste Platz finden. Bei unserer gewöhnlich nicht übermässig zahlreichen Präsenz an der GV sollten unsere Mitglieder ausreichend Platz finden, um dem Social Distancing gerecht zu werden, auch wenn es dann nicht mehr so aktuell sein sollte. 1. Protokoll der 92. Generalversammlung vom 29. Juni 2019 - liegt an der Generalversammlung auf.
    [Show full text]
  • 720 Zürich - Thalwil - Ziegelbrücke Zürich - Thalwil - Zug Stand: 17
    FAHRPLANJAHR 2021 720 Zürich - Thalwil - Ziegelbrücke Zürich - Thalwil - Zug Stand: 17. September 2020 SN8 S8 S24 75 S27 S8 S8 S24 46 S8 70 13787 18817 20417 2564 8219 18819 18819 20419 2409 18821 2611 SBB SBB SBB SBB SOB SBB SBB SBB SOB SBB SBB Pfäffikon ZH Winterthur Winterthur Winterthur Winterthur Zürich Flughafen ab 05 00 05 34 Zürich HB an 05 12 05 46 Zürich HB 04 14 05 07 05 21 05 35 05 37 05 37 05 51 06 05 06 07 06 10 Zürich Wiedikon 04 17 05 09 05 24 05 39 05 39 05 54 06 09 Zürich Enge 04 20 05 12 05 27 05 42 05 42 05 57 06 12 Zürich Wollishofen 04 22 05 14 05 29 05 44 05 44 05 59 06 14 Kilchberg ZH 04 24 05 17 05 32 05 47 05 47 06 02 06 17 Rüschlikon 04 27 05 20 05 35 05 50 05 50 06 05 06 20 Thalwil 04 31 05 23 05 38 05 45 05 53 05 53 06 08 06 23 Thalwil 04 31 05 24 05 38 05 46 05 54 05 54 06 08 06 24 Oberrieden Dorf 05 40 06 10 Horgen Oberdorf 05 44 06 14 Baar 05 52 05 58 06 22 Zug 05 56 06 02 06 26 06 29 06 31 Oberrieden 04 33 05 26 05 56 05 56 06 26 Horgen 04 37 05 30 06 00 06 00 06 30 Au ZH 04 40 05 33 06 03 06 03 06 33 Wädenswil 04 45 05 37 06 07 06 07 06 37 Richterswil 04 48 05 40 06 10 06 10 06 40 Bäch SZ 04 50 05 42 06 12 06 12 06 42 Freienbach SBB 04 52 05 45 06 15 06 15 06 45 Pfäffikon SZ 04 56 05 49 06 19 06 19 06 49 Pfäffikon SZ 05 01 06 29 06 30 Altendorf 05 04 06 32 06 34 Lachen SZ 05 07 06 34 06 36 Siebnen-Wangen 06 09 06 39 06 41 Schübelbach-Buttikon 06 11 06 41 06 43 Reichenburg 06 14 06 44 06 46 Bilten 06 17 06 47 06 50 Ziegelbrücke 06 22 06 53 06 55 [Rapperswil] Luzern [Locarno] Luzern [Bellinzona] 1 / 47 FAHRPLANJAHR 2021 720 Zürich - Thalwil - Ziegelbrücke Zürich - Thalwil - Zug Stand: 17.
    [Show full text]
  • Tickets & Prices
    Tickets & prices Valid from 11.12.2016 to 9.12.2017 GET ON BOARD. GET AHEAD. 3 Networked and interconnected Find your bearings Get in, get around, get there Table of contents The Zürcher Verkehrsverbund (Zurich Transport Network – ZVV) ZVV fares from zone to zone 6 is an umbrella organisation that covers all operators of public ZVV product range 7 transport within the canton of Zurich. “Networked mobility” is the ZVV NetworkPass 8–10 defining credo of ZVV: an interconnecting system of trains, trams, Ticket inspections 11 buses and boats that makes it easy to change from one mode ZVV BonusPass 12 of transport to another when travelling around. A dense route ZVV Annual Travelcard with Mobility 13 network, the regular interval timetable and efficient connecting Day passes 14 services all get you to your destination quickly, safely, punctually Multiple day passes 14/15 and relaxed. Single tickets 16 Multiple-journey tickets 17 Public holidays in the ZVV network area are: Zone upgrades 18 1 and 2 January, Good Friday, Easter Monday, Ascension Day, First-class upgrades 19 Whit Monday, 1 May, 1 August, 25 and 26 December. Local network tickets 20 Short-distance tickets 20 Subject to change. Bicycles on board 21 Special price reductions 22/23 ZVV 9 O’Clock Pass 24–27 Albis day pass 28 ZürichCARD 29 Night supplement 30/31 ZSG boat surcharge 31 Z-Pass 32 For destinations elsewhere in Switzerland 33 National tickets 34 ZVV timetable 35/36 ZVV-Contact, www.zvv.ch 37 ZVV ticket sales locations 38 Ticket machines 39 Screen functions at a glance 40 ZVV
    [Show full text]
  • Here's the Least Expensive Place to Live
    Investment Solutions & Products Swiss Economics Here’s the least expensive place to live Financial residential attractiveness| May 2021 Financial residential attractiveness RDI indicator 2021 Results for your household What's left after subtracting all mandatory Life in the city centers is expensive, but there are Here’s the least expensive place for you to live charges and fixed costs? often more attractive municipalities close by Page 9 Page 29 Page 46 Masthead Publisher: Credit Suisse AG, Investment Solutions & Products Dr. Nannette Hechler-Fayd'herbe Head of Global Economics & Research +41 44 333 17 06 nannette.hechler-fayd'[email protected] Dr. Sara Carnazzi Weber Head of Policy & Thematic Economics +41 44 333 58 82 [email protected] Editorial deadline May 4, 2021 Orders Electronic copies via credit-suisse.com/rdi Copyright The publication may be quoted provided the source is identified. Copyright © 2021 Credit Suisse Group AG and/or affiliate companies. All rights reserved. Source references Credit Suisse unless specified Authors Dr. Jan Schüpbach +41 44 333 77 36 [email protected] Emilie Gachet +41 44 332 09 74 [email protected] Pascal Zumbühl +41 44 334 90 48 [email protected] Dr. Sara Carnazzi Weber +41 44 333 58 82 [email protected] Contributions Fabian Diergardt Thomas Mendelin Marcin Jablonski Swiss Economics | Financial residential attractiveness 2021 2 Editorial Dear readers, For many people, choosing where to live is one of the most important decisions in life. In addition to geographical location and infrastructure, the availability of appropriate housing, emotional criteria and personal networks, financial factors also play a key role.
    [Show full text]