Characteristics and outcomes of out-of-hospital cardiac arrest in Japan

―All-Japan utstein registry including information on the location of arrest―

Abstract

Objective: We described the profiles of the All-Japan Utstein Registry including new information on the location of out-of-hospital cardiac arrest (OHCA) and investigated patient characteristics and outcomes after OHCA. Methods: The All-Japan Utstein Registry is a prospective population-based OHCA registry based on the international Utstein-style covering the entire population of Japan. The subjects of this study were OHCA patients enrolled in this registry from January 2013 to December 2015. Patients with OHCA that occurred before emergency medical service (EMS) arrival for whom cardiopulmonary resuscitation was attempted by bystanders or by EMS personnel and subsequently transported to medical institutions by the EMS were included. Patient characteristics, location of arrest, and survival outcomes after OHCA were described according to the resuscitation situations of patients (i.e., bystander-witness status, origin of cardiac arrest, and first documented rhythm). Results: During the 3-year study period, a total of 327,451 confirmed cases of OHCA occurring before the arrival of EMS were analyzed. Overall, 56.9% of all cases (186,276/327,451) were men and their mean age was 74.6 years (Standard deviation, 17.3). Approximately two-thirds of all OHCA incidents occurred at home (65.0%, 212,722/327,451). The locations of OHCA occurrence widely varied by the resuscitation situations of patients, e.g., OHCAs with ventricular fibrillation rhythm were more likely to be observed in public locations than at home. In total, the proportion of one-month survival with favorable neurological outcome was 2.2% (7,059/327,451). Bystander-witnessed OHCA cases of medical origin with ventricular fibrillation rhythm were likely to have better outcomes, and 25.0% of them (4,477/17,886) survived for one month with favorable neurological outcome. Conclusion: The All-Japan Utstein Registry including the information on the location of arrest enables us to reveal the location-specific features of OHCA. Investigations using this registry will lead to the establishment of effective strategies for prevention of OHCA occurrence and improving the survival after OHCA.