The response time threshold for predicting favourable neurological outcomes in patients with bystander-witnessed out-of-hospital cardiac arrest

Ono, Yuichi; Hayakawa, Mineji; Iijima, Hiroaki; Maekawa, Kunihiko; Kodate, Akira; Sadamoto, Yoshihiro; Mizugaki, Asumi; Murakami, Hiromoto; Katabami, Kenichi; Sawamura, Atsushi; Gando, Satoshi

doi:10.1016/j.resuscitation.2016.08.005

Cited by 37 publications

(21 citation statements)

References 33 publications

(21 reference statements)

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“…Figure 5 shows that there is a predominance of response time in significant nonconformity with what is prescribed by the World Health Organization (8 minutes) in places where there is low life expectancy, low public investment in health and follow average human development index (HDI) 43 . In locations where response time happens within the WHO's determined their conformity, can be seen high life expectancy, higher GDP percentage, more public investment in the area, expenditure, very high human development index and high life expectancy were identified [42][43][44] .…”

Section: ■ Resultsmentioning

confidence: 99%

Response time in the emergency services. Systematic review

et al. 2018

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The growth of the urban population raises concern about municipal public managers in the sense of providing emergency medical services (EMS) that are aligned with the needs of prehospital emergency medical care demanded by the population. The literature review aims at presenting the response time of emergency medical services in several parts of the world and discussing some factors that interfere in the result of this indicator such as GDP (Gross Domestic Product) percentage spent on health and life expectancy of countries. The study will also show that in some of the consulted articles, authors suggest to EMS recommendations for decreasing the response time using simulations, heuristics and metaheuristics. Response time is a basic indicator of emergency medical services, in such a way that researchers use the descriptive statistics to evaluate this parameter. Europe and the USA outstand in the publication of studies that present this information. Some articles use stochastic and mathematical methods to suggest models that simulate scenarios of response time reduction and suggest such proposals to the local EMS. Countries in which the response time was identified have a high index of human development and life expectancy between 74.7 and 83.7 years.

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Section: ■ Resultsmentioning

confidence: 99%

Response time in the emergency services. Systematic review

et al. 2018

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“…ROSC rate is associated with ambulance arrival time. The time longer than 10 minutes was correlated with a decreased number of ROSC [11,12,13]. We think, that a higher number of ROSC in cases like chest pain or syncope might be caused by cardiac arrest, that occurred while an ambulance was on the way.…”

Section: Resultsmentioning

confidence: 88%

Analysis of the reasons for ambulance being called for out of hospital sudden cardiac arrest. A retrospective multi-center study

Kłosiewicz

Skitek-Adamczak

Zieliński

et al. 2019

Pomeranian Journal of Life Sciences

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Introduction: The survival of sudden cardiac arrest (SCA) in addition to rapid diagnosis, implementation of high-quality cardiopulmonary resuscitation, immediate defibrillation also depends on the effective dispatching and cooperation of the emergency medical team members. Materials and methods: The research was a retrospective analysis of medical documentation kept in 2015. The provisions regarding interventions were analyzed in patients who were diagnosed with sudden cardiac arrest during the first medical contact undertaken by the emergency medical team -a total of 1136 events. Results:The mean age of SCA patients was 69.33 years. The main reason of calls was SCA (26.53%) and loss of consciousness (22.53%) although more than half of calls were connected other medical problems. Conclusions:The results allow you to conclude, that calls such as syncope, chest pain or breathing disorders should be treated as high priority and dispatcher assistance until ambulance arrival should be performed to ensure rapid instructions in case of SCA.ABSTRAKT Wstęp: Przeżywalność nagłego zatrzymania krążenia (NZK) zależy nie tylko od szybkiego rozpoznania, wdrożenia wysokiej jakości resuscytacji krążeniowo-oddechowej i bezzwłocznego przeprowadzenia defibrylacji, ale także od skutecznej współpracy zespołu ratownictwa medycznego. Materiały i metody: Badanie stanowiło retrospektywną analizę dokumentacji medycznej prowadzonej w 2015 r. Przeanalizowano zapisy dotyczące interwencji u pacjentów, u których w trakcie pierwszego kontaktu medycznego podjętego przez zespół ratownictwa stwierdzono nagłe zatrzymanie krążenia. Łącznie było to 1136 zdarzeń.Wyniki: Średnia wieku pacjentów z NZK wynosiła 69,33 lat. Główne przyczyny wezwań stanowiły: NZK (26,53%), utrata przytomności (22,53%), jednak więcej niż połowa zgłoszeń była związana z innymi problemami medycznymi. Wnioski: Wyniki badań pozwalają twierdzić, że wezwania do przypadków takich jak omdlenia, bóle w klatce piersiowej czy duszności powinny być traktowane jako zdarzenia o podwyższonym ryzyku wystąpienia NZK.

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“…Many previous studies have demonstrated that prehospital factors are associated with the outcomes of OHCA, such as location of OHCA [3,13], EMS response time [15,16], attended by EMT-Paramedic [17], and witness of OHCA [18]. Some studies attempted to exam the in uence of bystander CPR on OHCA outcomes, but the results were inconclusive.…”

Section: Discussionmentioning

confidence: 99%

“…OHCAs occurring in different areas might impact the EMS response time, and might re ect different socioeconomic status of the countries [3,10]. Shorter response time, younger age, OHCA occurring during the daytime, urban areas, and socioeconomic status are usually associated with better prognosis [15,16,24,25]. However, people who have OHCAs in public locations tend to be healthier, are able to move freely, and probably have less comorbidity, and thus have better outcomes [26].…”

Section: Discussionmentioning

confidence: 99%

“…EMS response time was de ned as the duration of time from when a call is made to the EMS to the point when the EMT arrive at the scene. Recently, several studies revealed that shorter EMS response time could improve outcome of OHCA [15,16,21,27]. Shorter EMS response time was associated with a higher rate of survival to discharge and of 1 year survival [27].…”

Section: Discussionmentioning

confidence: 99%

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Association Between Modifiable Prehospital Prognostic Factors on Out-Of-Hospital Cardiac Arrest in Different Age Groups

Huang

Lee

et al. 2020

Preprint

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Background The prognosis of out-of-hospital cardiac arrest (OHCA) is very poor. While several prehospital factors are known to be associated with improved survival, the impact of prehospital factors on different age groups is unclear. The objective of the study was to access the impact of prehospital factors and pre-existing comorbidities on OHCA outcomes in different age groupsMethods A retrospective observational analysis was conducted using the emergency medical service (EMS) database from January 2015 to December 2019. We collected information on prehospital factors, underlying diseases, and outcome of OHCAs in different age groups. Kaplan-Meier type survival curves and multivariable logistic regression were used to analyze the association between modifiable pre-hospital factors and outcomes. Results A total of 4188 witnessed adult OHCAs were analyzed. For the younger group (age ≦75 years old), after adjustment for confounding factors, EMS response time (odds ratio [OR]=0.860, 95% confidence interval [CI]: 0.811-0.909, p<0.001), public location (OR=1.843, 95% CI: 1.179-1.761, p<0.001), bystander CPR (OR=1.329, 95% CI: 1.007-1.750, p=0.045), attendance by an EMT-Paramedic (OR=1.666, 95% CI: 1.277-2.168, p<0.001), and prehospital defibrillation by automated external defibrillator (AED)(OR=1.666, 95% CI: 1.277-2.168, p<0.001) were prognostic factors for OHCA. For the older group (age >75 years old), age (OR=0.924, CI: 0.880-0.966, p=0.001), EMS response time (OR=0.833, 95% CI: 0.742-0.928, p=0.001), public location (OR=4.290, 95% CI: 2.450-7.343, p<0.001), and attendance by an EMT-Paramedic (OR=2.702, 95% CI: 1.704-4.279, p<0.001) were independent prognostic factors for OHCA.Conclusions There were variations between younger and older OHCA patients. We found that bystander CPR and prehospital defibrillation by AED were independent prognostic factors for younger OHCA patients but not for the older group.

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The response time threshold for predicting favourable neurological outcomes in patients with bystander-witnessed out-of-hospital cardiac arrest

Cited by 37 publications

References 33 publications

Response time in the emergency services. Systematic review

Response time in the emergency services. Systematic review

Analysis of the reasons for ambulance being called for out of hospital sudden cardiac arrest. A retrospective multi-center study

Association Between Modifiable Prehospital Prognostic Factors on Out-Of-Hospital Cardiac Arrest in Different Age Groups

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