TY - JOUR
T1 - An epidemiological assessment of choking-induced out-of-hospital cardiac arrest
T2 - A post hoc analysis of the SOS-KANTO 2012 study
AU - Miyoshi, Takahiro
AU - Endo, Hideki
AU - Yamamoto, Hiroyuki
AU - Gonmori, Satoshi
AU - Miyata, Hiroaki
AU - Takuma, Kiyotsugu
AU - Sakurai, Atsushi
AU - Kitamura, Nobuya
AU - Tagami, Takashi
AU - Nakada, Taka aki
AU - Takeda, Munekazu
N1 - Funding Information:
Dr. Yamamoto received consultation fees from Mitsubishi Tanabe Pharma, speaker fees from Chugai Pharmaceutical Co., ltd., and Ono Pharmaceutical Co., ltd., and payment for a manuscript from Astellas Pharma Inc. Dr. Miyata received a research grant from AstraZeneca K.K. for an independent research project through the PeoPLe Consortium at Keio University. Drs. Endo, Yamamoto, and Miyata are affiliated with the Department of Healthcare Quality Assessment at the University of Tokyo. This department is a social collaboration department supported by the National Clinical Database, Johnson & Johnson K.K., Nipro Corporation, and Intuitive Surgical Sàrl. The other authors report no conflicts of interest that are directly relevant to the content of this article.
Funding Information:
The authors would like to thank the secretariat members and all participants of the Japanese Association for Acute Medicine of Kanto who assisted in the collection of the data and the coordination of this project. This study was carried out with the support of the Japanese Association for Acute Medicine of Kanto.
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/12
Y1 - 2022/12
N2 - Objectives: The aim of this study was to reveal the neurological outcomes of choking-induced out-of-hospital cardiac arrest (OHCA) and evaluate the presence of witnesses, cardiopulmonary resuscitation (CPR) performed by a witness (bystander-witnessed CPR), and the proportion of patients with favourable neurological outcomes by the time from CPR by emergency medical services (EMS) to the return of spontaneous circulation (ROSC) (CPR-ROSC time). Methods: We retrospectively analysed the SOS-KANTO 2012 database, which included data of 16,452 OHCAs in Japan. We selected choking-induced OHCA patients aged ≥ 20 years. We evaluated the neurological outcomes at 1 month with the Cerebral Performance Category (CPC). We defined favourable neurological outcomes (CPCs: 1–2) and present the outcomes with descriptive statistics. Results: Of 1,045 choking-induced OHCA patients, 18 (1.7%) had a favourable neurological outcome. Of 1,045 OHCAs, 757 (72.6%) were witnessed, and 375 (36.0%) underwent bystander-witnessed CPR. Of the 18 OHCAs with favourable outcomes, 17 (94.4%) were witnessed, and 11 (61.1%) underwent bystander-witnessed CPR. With a CPR-ROSC time of 0–5 minutes, the proportion of patients with favourable neurological outcomes was 29.7%, ranging from 0% to 6% in the following time groups. Conclusions: The neurological outcome of choking-induced OHCA was poor. The neurological outcomes deteriorated rapidly from 5 minutes after the initiation of CPR by EMS. The presence of witnesses and bystander-witnessed CPR may be factors that contribute to improved outcomes, but the effects were not remarkable. As another approach to reduce deaths due to choking, citizen education for the prevention of choking may be effective.
AB - Objectives: The aim of this study was to reveal the neurological outcomes of choking-induced out-of-hospital cardiac arrest (OHCA) and evaluate the presence of witnesses, cardiopulmonary resuscitation (CPR) performed by a witness (bystander-witnessed CPR), and the proportion of patients with favourable neurological outcomes by the time from CPR by emergency medical services (EMS) to the return of spontaneous circulation (ROSC) (CPR-ROSC time). Methods: We retrospectively analysed the SOS-KANTO 2012 database, which included data of 16,452 OHCAs in Japan. We selected choking-induced OHCA patients aged ≥ 20 years. We evaluated the neurological outcomes at 1 month with the Cerebral Performance Category (CPC). We defined favourable neurological outcomes (CPCs: 1–2) and present the outcomes with descriptive statistics. Results: Of 1,045 choking-induced OHCA patients, 18 (1.7%) had a favourable neurological outcome. Of 1,045 OHCAs, 757 (72.6%) were witnessed, and 375 (36.0%) underwent bystander-witnessed CPR. Of the 18 OHCAs with favourable outcomes, 17 (94.4%) were witnessed, and 11 (61.1%) underwent bystander-witnessed CPR. With a CPR-ROSC time of 0–5 minutes, the proportion of patients with favourable neurological outcomes was 29.7%, ranging from 0% to 6% in the following time groups. Conclusions: The neurological outcome of choking-induced OHCA was poor. The neurological outcomes deteriorated rapidly from 5 minutes after the initiation of CPR by EMS. The presence of witnesses and bystander-witnessed CPR may be factors that contribute to improved outcomes, but the effects were not remarkable. As another approach to reduce deaths due to choking, citizen education for the prevention of choking may be effective.
KW - Bystander-witnessed CPR
KW - Cardiopulmonary resuscitation
KW - Choking
KW - Out-of-hospital cardiac arrest
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U2 - 10.1016/j.resuscitation.2022.10.022
DO - 10.1016/j.resuscitation.2022.10.022
M3 - Article
C2 - 36334841
AN - SCOPUS:85142217298
SN - 0300-9572
VL - 181
SP - 311
EP - 319
JO - Resuscitation
JF - Resuscitation
ER -