Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Trends in In-Hospital Advanced Management and Survival of Out-of-Hospital Cardiac Arrest Among Adults From 2013 to 2017 ― A Multicenter, Prospective Registry in Osaka, Japan ―
Satoshi YoshimuraAtsushi HirayamaTakeyuki KiguchiTaro IrisawaTomoki YamadaKazuhisa YoshiyaChanghwi ParkTetsuro NishimuraTakuya IshibeYoshiki YagiMasafumi KishimotoToshiya InoueYasuyuki HayashiTaku SogabeTakaya MorookaHaruko SakamotoKeitaro SuzukiFumiko NakamuraTasuku MatsuyamaYohei OkadaNorihiro NishiokaDaisuke KobayashiSatoshi MatsuiShunsuke KimataTakeshi ShimazuTetsuhisa KitamuraTaku Iwamion behalf of the CRITICAL Study Group Investigators
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論文ID: CJ-20-1022


Background:The aim of our study was to investigate in detail the temporal trends in in-hospital characteristics, actual management, and survival, including neurological status, among adult out-of-hospital cardiac arrest (OHCA) patients in recent years.

Methods and Results:From the prospective database of the Comprehensive Registry of Intensive Care for OHCA Survival (CRITICAL) study in Osaka, Japan, we enrolled all OHCA patients aged ≥18 years for whom resuscitation was attempted, and who were transported to participating hospitals between the years 2013 and 2017. The primary outcome measure was 1-month survival with favorable neurological outcome after OHCA. Temporal trends in in-hospital management and favorable neurological outcome among adult OHCA patients were assessed. Of the 11,924 patients in the database, we included a total of 10,228 adult patients from 16 hospitals. As for in-hospital advanced treatments, extracorporeal cardiopulmonary resuscitation (ECPR) use increased from 2.4% in 2013 to 4.3% in 2017 (P for trend <0.001). However, the proportion of adult OHCA patients with favorable neurological outcome did not change during the study period (from 5.7% in 2013 to 4.4% in 2017, adjusted odds ratio (OR) for 1-year increment: 0.98 (95% confidence interval: 0.94–1.23)).

Conclusions:In this target population, in-hospital management such as ECPR increased slightly between 2013 and 2017, but 1-month survival with favorable neurological outcome after adult OHCA did not improve significantly.


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