Prehospital cardiopulmonary resuscitation duration and neurological outcome after adult out-of-hospital cardiac arrest by location of arrest

被引:3
作者
Kishimori, Takefumi [1 ]
Matsuyama, Tasuku [2 ]
Kiyohara, Kosuke [3 ]
Kitamura, Tetsuhisa [4 ]
Shida, Haruka [1 ]
Kiguchi, Takeyuki [5 ]
Nishiyama, Chika [6 ]
Kobayashi, Daisuke [5 ]
Okabayashi, Satoe [5 ]
Shimamoto, Tomonari [5 ]
Sado, Junya [7 ]
Kawamura, Takashi [5 ]
Iwami, Taku [5 ]
机构
[1] Kyoto Univ, Dept Prevent Serv, Grad Sch Med, Kyoto, Japan
[2] Kyoto Prefectural Univ Med, Dept Emergency Med, Kyoto, Japan
[3] Otsuma Womens Univ, Dept Food Sci, Tokyo, Japan
[4] Osaka Univ, Dept Social & Environm Med, Suita, Osaka, Japan
[5] Kyoto Univ Hlth Serv, Kyoto, Japan
[6] Kyoto Univ, Dept Crit Care Nursing, Grad Sch Human Hlth Sci, Kyoto, Japan
[7] Osaka Univ, Grad Sch Med, Dept Hlth & Sport Sci, Suita, Osaka, Japan
关键词
Out-of-hospital cardiac arrest; prehospital cardiopulmonary resuscitation duration; location of arrest; favourable neurological outcome; AMERICAN-HEART-ASSOCIATION; EUROPEAN RESUSCITATION; NURSING-HOMES; SURVIVAL; IMPACT; NATIONWIDE; REGISTRY; UPDATE; DEFIBRILLATION; GUIDELINES;
D O I
10.1177/2048872620921598
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Little is known about the association between prehospital cardiopulmonary resuscitation duration for adults with out-of-hospital cardiac arrest and outcome by the location of arrests. This study aimed to investigate the association between prehospital cardiopulmonary resuscitation duration and one-month survival with favourable neurological outcome. Methods We analysed 276,391 adults aged 18 years and older with out-of-hospital cardiac arrest of medical origin before emergency medical service arrival. Prehospital cardiopulmonary resuscitation duration was defined as the time from emergency medical service-initiated cardiopulmonary resuscitation to prehospital return of spontaneous circulation or to hospital arrival. The primary outcome was one-month survival with favourable neurological outcome (cerebral performance category 1 or 2). The association between prehospital cardiopulmonary resuscitation duration and favourable neurological outcome was assessed using univariable and multivariable logistic regression analyses. Results The proportion of favourable neurological outcomes was 2.3% in total, 7.6% in public locations, 1.5% in residential locations and 0.7% in nursing homes (P < 0.001). In univariable and multivariable logistic regression analyses, longer prehospital cardiopulmonary resuscitation duration was associated with poor neurological outcome, regardless of arrest location (P for trend < 0.001). Patients with shockable rhythm in both public and residential locations had better neurological outcome than those in nursing homes at any time point, and residential and public locations had a similar neurological outcome tendency among patients with shockable rhythm. Conclusions Longer prehospital cardiopulmonary resuscitation duration was independently associated with a lower proportion of patients with favourable neurological outcomes. Moreover, the association between prehospital cardiopulmonary resuscitation duration and neurological outcome differed according to the location of arrest and the first documented rhythm.
引用
收藏
页码:S90 / S99
页数:10
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