Incidence and survival rate of bystander-witnessed out-of-hospital cardiac arrest with cardiac etiology in Osaka, Japan: a population-based study according to the Utstein style

Nishiuchi, Tatsuya; Hiraide, Atsushi; Hayashi, Yasuyuki; Uejima, Tokuhisa; Morita, Hiroshi; Yukioka, Hidekazu; Shigemoto, Tatsuhiro; Ikeuchi, Hisashi; Matsusaka, Masanori; Iwami, Taku; Shinya, Hiroshi; Yokota, Junichiro

doi:10.1016/s0300-9572(03)00241-7

Cited by 49 publications

(23 citation statements)

References 23 publications

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“…Herlitz et al also revealed that 42% of men and 25% of women with IHCA had a previous history of myocardial infarction [18]. The relatively low frequency of ischemic heart disease in this study is comparable to that of an out-of-hospital cardiac arrest study in Japan [19]. Accordingly, it also accounted for the very low incidence (3.9%) of VT/VF as the first documented rhythm in this study.…”

Section: Factorsupporting

confidence: 75%

Outcome of In-Hospital Cardiac Arrest in Adult General Wards

Kung¹,

Cheng²,

Hung³

et al. 2014

IJCM

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Objective: Few studies have focused on factors influencing outcomes of patients with in-hospital cardiac arrest (IHCA) in general wards. The goal of this study was to report the outcomes of adult patients with IHCA in the general wards and identified the prognostic factors. Methods: Adult patients with IHCA having received cardiopulmonary resuscitation in general wards from January 2008 to December 2011 were retrospectively reviewed from our registry system. The primary outcome was survival to hospital discharge, while the secondary outcome was sustained return of spontaneous circulation (ROSC). Results: A total of 544 general ward patients were analyzed for event variables and resuscitation results. The rate of establishing a ROSC was 40.1% and the rate of survival to discharge was 5.1%. Ventricular tachycardia/ventricular fibrillation (VT/VF) was the initial rhythm in 3.9% of patients. Pre-arrest factors including a high Charlson comorbidity index (CCI) ≥ 9 (OR 0.251, 95% CI 0.098 -0.646), cardiac comorbidity (OR 0.612, 95% CI 0.401 -0.933), and arrest time on the midnight shift (OR 0.403, 95% CI 0.252 -0.642) were independently associated with a low possibility of ROSC. The initial VT/VF presenting rhythms (OR 0.135, 95% CI 0.030 -0.601) were independently associated with a high survival rate, whereas patients with deteriorated disease course were independently associated with a decreased hospital survival (OR 3.902, 95% CI 1.619 -9.403). Conclusions: We demonstrated that pre-arrest factors can predict patient outcome after IHCA in general wards, including the association of a CCI ≥ 9 and cardiac comorbidity with poor ROSC, and deteriorated disease course as an independent predictor of a low survival rate.

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Section: Factorsupporting

confidence: 75%

Outcome of In-Hospital Cardiac Arrest in Adult General Wards

Kung¹,

Cheng²,

Hung³

et al. 2014

IJCM

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“…1 Compared with the preceding studies in Japan, 8,9 the time interval from collapse to EMS maneuvers was slightly longer in this study, and these delays might result in low frequency of initial VF. The racial difference in VF incidence observed in OHCAs of cardiac origin 29,30 might be another possible explanation. Because of this low frequency of VF among OHCAs of noncardiac origin and high survival after OHCA of cardiac origin in Japan, 31,32 the low survival after OHCAs of noncardiac origin shown in this study would not be associated with the EMS system in this area but with the origins of the OHCAs.…”

Section: Discussionmentioning

confidence: 99%

Bystander-Initiated Rescue Breathing for Out-of-Hospital Cardiac Arrests of Noncardiac Origin

et al. 2010

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Background-Although chest compression-only cardiopulmonary resuscitation (CPR) is effective for adult out-ofhospital cardiac arrest (OHCA) of cardiac origin, it remains uncertain whether bystander-initiated rescue breathing has an incremental benefit for OHCA of noncardiac origin. Methods and Results-A nationwide, prospective, population-based, observational study covering the whole population of Japan and involving consecutive OHCA patients with emergency responder resuscitation attempts was conducted from January 2005 through December 2007. The primary outcome was neurologically intact 1-month survival. Multiple logistic regression analysis was used to assess the contribution of bystander-initiated CPR to better neurological outcomes. Among a total of 43 246 bystander-witnessed OHCAs of noncardiac origin, 8878 (20.5%) received chest compression-only CPR, and 7474 (17.3%) received conventional CPR with rescue breathing. The conventional CPR group (1.8%) had a higher rate of better neurological outcome than both the no CPR group (1.4%; odds ratio, 1.58; 95% confidence interval, 1.28 to 1.96) and the compression-only CPR group (1.5%; odds ratio, 1.32; 95% confidence interval, 1.03 to 1.69). However, the compression-only CPR group did not produce better neurological outcome than the no CPR group (odds ratio, 1.19; 95% confidence interval, 0.96 to 1.47). The number of OHCAs needed to treat with conventional CPR versus compression-only CPR to save a life with favorable neurological outcome after OHCA was 290. Conclusions-This nationwide observational study indicates that rescue breathing has an incremental benefit for OHCAs of noncardiac origin, but the impact on the overall survival after OHCA was small. (Circulation. 2010;122:293-299.)

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“…Four studies limited their analysis to OHCA cases that were not witnessed by EMS providers 78,97,99,103 ; 6 studies reported survival at 1 month rather than at hospital discharge 2,81,85,90,95,108 ; 3 studies reported survival 1 year post OHCA 52,103,105 ; and 2 studies grouped pulseless electric activity and asystole together. 55,95 Excluding these studies did not appreciably alter our final pooled results.…”

Section: Sensitivity Analysesmentioning

confidence: 99%