Out-of-Hospital Cardiac Arrest and Survival-An Epidemiological Analysis of Emergency Service Reports in a Large City in Japan-

Abstract

BackgroundThe factors that influence survival of out-of-hospital cardiac arrest in Japan have not been fully investigated. Methods and ResultsThe official emergency service record was used to investigate 1,600 patients for whom cardiopulmonary resuscitation was attempted by the city's emergency personnel. Only 45 (2.8%) patients survived for 1 month. The survival rate was 9.8% in the patients under 20 years of age, with a marked decreasing trend to 0.8% in the patients aged 80 years or older. The rate peaked at 4.8% on Sunday and bottomed out at 0.5% on Thursday, forming a distinct sine curve. The survival rate was 9.9% when an ambulance arrived at the scene within 4 min, with a steep drop to 2.5% when 4-7 min elapsed. However, the rate was not significantly different by the interval to hospital. Although bystander resuscitation did not significantly affect the survival, paramedics on board significantly improved the rate (3.5% vs 1.6%). Multivariate analysis confirmed that age, day of the week, place, interval to ambulance's arrival, and personnel on board were independently associated with the probability of survival. Conclusions Quick arrival of a paramedic team would improve the survival after out-of-hospital cardiac arrest. General education of lifesaving techniques would be another key factor. (Circ J 2004; 68: 603 -609)

Workload during cardiopulmonary resuscitation

“…There is a general consensus that trained lay people performing cardiopulmonary resuscitation (CPR) can save life. Therefore, the training is recommended for the general population (e.g., Kida et al 2004, Stiell et al 2003, although there are some barriers (Lejeune and Delooz 1987) (Johnston et al 2003). Such barriers and differences in the availability of CPR trainings cause significant regional differences: While lay rescuer CPR rates are low in Germany (10-15 %), they are much higher in Scandinavia (up to 50 %).…”