The association of delayed advanced airway management and neurological outcome after out-of-hospital cardiac arrest in Japan

被引:7
作者
Nakagawa, Koshi [1 ,6 ]
Sagisaka, Ryo [2 ,3 ]
Morioka, Daigo [4 ]
Tanaka, Shota [3 ,5 ]
Takyu, Hiroshi [1 ]
Tanaka, Hideharu [1 ,3 ]
机构
[1] Kokushikan Univ, Grad Sch, Dept Emergency Med Syst, Tokyo, Japan
[2] Chuo Univ, Fac Sci & Engn, Dept Integrated Sci & Engn Sustainable Soc, Tokyo, Japan
[3] Kokushikan Univ, Res Inst Disaster Management & EMS, Tokyo, Japan
[4] Meiji Univ Integrat Med, Sch Emergency Med Sci, Kyoto, Japan
[5] Tokai Univ, Sch Med, Isehara, Kanagawa, Japan
[6] Kokushikan Univ, 7-3-1 Nagayama, Tama, Tokyo 2058515, Japan
关键词
Out-of-hospital cardiac arrest; Advanced airway management; Prehospital care; Advanced life support; Multilevel analysis; AMERICAN-HEART-ASSOCIATION; INTERNATIONAL LIAISON COMMITTEE; EUROPEAN RESUSCITATION COUNCIL; PULSELESS ELECTRICAL-ACTIVITY; HEALTH-CARE PROFESSIONALS; ADVANCED LIFE-SUPPORT; CARDIOPULMONARY-RESUSCITATION; ENDOTRACHEAL INTUBATION; SPONTANEOUS CIRCULATION; TRACHEAL INTUBATION;
D O I
10.1016/j.ajem.2022.10.010
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction: The effectiveness of advanced airway management (AAM) for out-of-hospital cardiac arrest (OHCA) has been reported differently in each region; however, no study has accounted for the regional differences in the association between the timing of AAM implementation and neurological outcomes.Objective: This study aimed to evaluate the association between the timing of patient or prefecture level AAM and a favorableneurological outcome defined by cerebral performance category 1 or 2 (CPC 1-2).Methods: A retrospective cohort study was conducted using data from the All-Japan Utstein Registry between 2013 and 2017. We included patients aged >= 8 years with OHCA for whom AAM (i.e., supraglottic airway or en-dotracheal intubation) was performed in a prehospital setting (n = 182,913). We divided the patients into shockable (n = 11,740) and non-shockable (n = 171,173) cohorts based on the initial electrocardiogram rhythm. Multilevel logistic regression analysis estimated the association between AAM time (patient contact-to-AAM performance interval) at the patient level (1-min unit increments), prefecture level (> 9.2 min vs. <= 9.2 min) and CPC 1-2.Results: A delay in AAM time was negatively associated with CPC 1-2 (adjusted odds ratio [AOR], 0.92, 0.96; 95% confidence interval [CI], 0.90-0.93, 0.95-0.97, respectively), regardless of initial rhythm. At the prefecture level, a delay in AAM time was negatively associated with CPC 1-2 (AOR, 0.77, 0.68; 95% CI, 0.58-1.04, 0.50-0.94, respec-tively) only in the non-shockable cohort.Conclusion: A delay in AAM performance was negatively associated with CPC 1-2 in both shockable and non -shockable cohorts. Moreover, a delay in AAM performance at the prefecture level was negatively associated with CPC 1-2 in the non-shockable cohort.(c) 2022 Elsevier Inc. All rights reserved.
引用
收藏
页码:89 / 95
页数:7
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