Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: A prospective cohort study

The SOS-KANTO 2012 Study Group

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The duration of cardiopulmonary resuscitation (CPR) is an important factor associated with the outcomes for an out-of-hospital cardiac arrest. However, the appropriate CPR duration remains unclear considering pre- and in-hospital settings. The present study aimed to evaluate the relationship between the CPR duration (including both the pre- and in-hospital duration) and neurologically favorable outcomes 1-month after cardiac arrest. Methods: Data were utilized from a prospective multi-center cohort study of out-of-hospital cardiac arrest patients transported to 67 emergency hospitals between January 2012 and March 2013 in the Kanto area of Japan. A total of 3,353 patients with out-of-hospital cardiac arrest (age ≥18years) who underwent CPR by emergency medical service personnel and achieved the return of spontaneous circulation in a pre- or in-hospital setting were analyzed. The primary outcome was a 1-month favorable neurological outcome. Logistic regression analysis was performed to estimate the influence of cardiopulmonary resuscitation duration. The CPR duration that achieved a cumulative proportion >99% of cases with a 1-month neurologically favorable outcome was determined. Results: Of the 3,353 eligible cases, pre-hospital return of spontaneous circulation was obtained in 1,692 cases (50.5%). A total of 279 (8.3%) cases had a 1-month neurologically favorable outcome. The CPR duration was significantly and inversely associated with 1-month neurologically favorable outcomes with adjustment for pre- and in-hospital confounders (adjusted odds ratio: 0.911, per minute, 95% CI: 0.892-0.929, p < 0.001). After 30min of CPR, the probability of a 1-month neurologically favorable outcome decreased from 8.3 to 0.7%. At 45min of CPR, the cumulative proportion for a 1-month neurologically favorable outcome reached >99%. Conclusions: The CPR duration was independently and inversely associated with 1-month neurologically favorable outcomes after out-of-hospital cardiac arrest. The CPR duration required to achieve return of spontaneous circulation in >99% of out-of-hospital cardiac arrest patients with a 1-month favorable neurological outcome was 45min, considering both pre- and in-hospital settings.

Original languageEnglish
Article number59
JournalBMC Anesthesiology
Volume17
Issue number1
DOIs
Publication statusPublished - 2017 Apr 21

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Out-of-Hospital Cardiac Arrest
Cardiopulmonary Resuscitation
Cohort Studies
Prospective Studies
Emergency Medical Services
Heart Arrest
Japan
Emergencies
Logistic Models
Odds Ratio
Regression Analysis

Keywords

  • Cardiopulmonary resuscitation
  • Emergency medical services
  • Out-of-hospital cardiac arrest
  • Patient outcome assessment

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest : A prospective cohort study. / The SOS-KANTO 2012 Study Group.

In: BMC Anesthesiology, Vol. 17, No. 1, 59, 21.04.2017.

Research output: Contribution to journalArticle

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title = "Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: A prospective cohort study",
abstract = "Background: The duration of cardiopulmonary resuscitation (CPR) is an important factor associated with the outcomes for an out-of-hospital cardiac arrest. However, the appropriate CPR duration remains unclear considering pre- and in-hospital settings. The present study aimed to evaluate the relationship between the CPR duration (including both the pre- and in-hospital duration) and neurologically favorable outcomes 1-month after cardiac arrest. Methods: Data were utilized from a prospective multi-center cohort study of out-of-hospital cardiac arrest patients transported to 67 emergency hospitals between January 2012 and March 2013 in the Kanto area of Japan. A total of 3,353 patients with out-of-hospital cardiac arrest (age ≥18years) who underwent CPR by emergency medical service personnel and achieved the return of spontaneous circulation in a pre- or in-hospital setting were analyzed. The primary outcome was a 1-month favorable neurological outcome. Logistic regression analysis was performed to estimate the influence of cardiopulmonary resuscitation duration. The CPR duration that achieved a cumulative proportion >99{\%} of cases with a 1-month neurologically favorable outcome was determined. Results: Of the 3,353 eligible cases, pre-hospital return of spontaneous circulation was obtained in 1,692 cases (50.5{\%}). A total of 279 (8.3{\%}) cases had a 1-month neurologically favorable outcome. The CPR duration was significantly and inversely associated with 1-month neurologically favorable outcomes with adjustment for pre- and in-hospital confounders (adjusted odds ratio: 0.911, per minute, 95{\%} CI: 0.892-0.929, p < 0.001). After 30min of CPR, the probability of a 1-month neurologically favorable outcome decreased from 8.3 to 0.7{\%}. At 45min of CPR, the cumulative proportion for a 1-month neurologically favorable outcome reached >99{\%}. Conclusions: The CPR duration was independently and inversely associated with 1-month neurologically favorable outcomes after out-of-hospital cardiac arrest. The CPR duration required to achieve return of spontaneous circulation in >99{\%} of out-of-hospital cardiac arrest patients with a 1-month favorable neurological outcome was 45min, considering both pre- and in-hospital settings.",
keywords = "Cardiopulmonary resuscitation, Emergency medical services, Out-of-hospital cardiac arrest, Patient outcome assessment",
author = "{The SOS-KANTO 2012 Study Group} and Masahiro Kashiura and Yuichi Hamabe and Akiko Akashi and Atsushi Sakurai and Yoshio Tahara and Naohiro Yonemoto and Ken Nagao and Arino Yaguchi and Naoto Morimura and Naoto Morimura and Atsushi Sakurai and Yoshio Tahara and Arino Yaguchi and Ken Nagao and Tagami Takashi and Dai Miyazaki and Tomoko Ogasawara and Kei Hayashida and Masaru Suzuki and Mari Amino and Nobuya Kitamura and Tomohisa Nomura and Naoki Shimizu and Akiko Akashi and Naohiro Yonemoto and Sadaki Inokuchi and Yoshihiro Masui and Kunihisa Miura and Haruhiko Tsutsumi and Kiyotsugu Takuma and Ishihara Atsushi and Minoru Nakano and Hiroshi Tanaka and Keiichi Ikegami and Takao Arai and Arino Yaguchi and Nobuya Kitamura and Shigeto Oda and Kenji Kobayashi and Takayuki Suda and Kazuyuki Ono and Naoto Morimura and Ryosuke Furuya and Yuichi Koido and Fumiaki Iwase and Ken Nagao and Shigeru Kanesaka and Yasusei Okada and Kyoko Unemoto and Tomohito Sadahiro",
year = "2017",
month = "4",
day = "21",
doi = "10.1186/s12871-017-0351-1",
language = "English",
volume = "17",
journal = "BMC Anesthesiology",
issn = "1471-2253",
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number = "1",

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TY - JOUR

T1 - Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest

T2 - A prospective cohort study

AU - The SOS-KANTO 2012 Study Group

AU - Kashiura, Masahiro

AU - Hamabe, Yuichi

AU - Akashi, Akiko

AU - Sakurai, Atsushi

AU - Tahara, Yoshio

AU - Yonemoto, Naohiro

AU - Nagao, Ken

AU - Yaguchi, Arino

AU - Morimura, Naoto

AU - Morimura, Naoto

AU - Sakurai, Atsushi

AU - Tahara, Yoshio

AU - Yaguchi, Arino

AU - Nagao, Ken

AU - Takashi, Tagami

AU - Miyazaki, Dai

AU - Ogasawara, Tomoko

AU - Hayashida, Kei

AU - Suzuki, Masaru

AU - Amino, Mari

AU - Kitamura, Nobuya

AU - Nomura, Tomohisa

AU - Shimizu, Naoki

AU - Akashi, Akiko

AU - Yonemoto, Naohiro

AU - Inokuchi, Sadaki

AU - Masui, Yoshihiro

AU - Miura, Kunihisa

AU - Tsutsumi, Haruhiko

AU - Takuma, Kiyotsugu

AU - Atsushi, Ishihara

AU - Nakano, Minoru

AU - Tanaka, Hiroshi

AU - Ikegami, Keiichi

AU - Arai, Takao

AU - Yaguchi, Arino

AU - Kitamura, Nobuya

AU - Oda, Shigeto

AU - Kobayashi, Kenji

AU - Suda, Takayuki

AU - Ono, Kazuyuki

AU - Morimura, Naoto

AU - Furuya, Ryosuke

AU - Koido, Yuichi

AU - Iwase, Fumiaki

AU - Nagao, Ken

AU - Kanesaka, Shigeru

AU - Okada, Yasusei

AU - Unemoto, Kyoko

AU - Sadahiro, Tomohito

PY - 2017/4/21

Y1 - 2017/4/21

N2 - Background: The duration of cardiopulmonary resuscitation (CPR) is an important factor associated with the outcomes for an out-of-hospital cardiac arrest. However, the appropriate CPR duration remains unclear considering pre- and in-hospital settings. The present study aimed to evaluate the relationship between the CPR duration (including both the pre- and in-hospital duration) and neurologically favorable outcomes 1-month after cardiac arrest. Methods: Data were utilized from a prospective multi-center cohort study of out-of-hospital cardiac arrest patients transported to 67 emergency hospitals between January 2012 and March 2013 in the Kanto area of Japan. A total of 3,353 patients with out-of-hospital cardiac arrest (age ≥18years) who underwent CPR by emergency medical service personnel and achieved the return of spontaneous circulation in a pre- or in-hospital setting were analyzed. The primary outcome was a 1-month favorable neurological outcome. Logistic regression analysis was performed to estimate the influence of cardiopulmonary resuscitation duration. The CPR duration that achieved a cumulative proportion >99% of cases with a 1-month neurologically favorable outcome was determined. Results: Of the 3,353 eligible cases, pre-hospital return of spontaneous circulation was obtained in 1,692 cases (50.5%). A total of 279 (8.3%) cases had a 1-month neurologically favorable outcome. The CPR duration was significantly and inversely associated with 1-month neurologically favorable outcomes with adjustment for pre- and in-hospital confounders (adjusted odds ratio: 0.911, per minute, 95% CI: 0.892-0.929, p < 0.001). After 30min of CPR, the probability of a 1-month neurologically favorable outcome decreased from 8.3 to 0.7%. At 45min of CPR, the cumulative proportion for a 1-month neurologically favorable outcome reached >99%. Conclusions: The CPR duration was independently and inversely associated with 1-month neurologically favorable outcomes after out-of-hospital cardiac arrest. The CPR duration required to achieve return of spontaneous circulation in >99% of out-of-hospital cardiac arrest patients with a 1-month favorable neurological outcome was 45min, considering both pre- and in-hospital settings.

AB - Background: The duration of cardiopulmonary resuscitation (CPR) is an important factor associated with the outcomes for an out-of-hospital cardiac arrest. However, the appropriate CPR duration remains unclear considering pre- and in-hospital settings. The present study aimed to evaluate the relationship between the CPR duration (including both the pre- and in-hospital duration) and neurologically favorable outcomes 1-month after cardiac arrest. Methods: Data were utilized from a prospective multi-center cohort study of out-of-hospital cardiac arrest patients transported to 67 emergency hospitals between January 2012 and March 2013 in the Kanto area of Japan. A total of 3,353 patients with out-of-hospital cardiac arrest (age ≥18years) who underwent CPR by emergency medical service personnel and achieved the return of spontaneous circulation in a pre- or in-hospital setting were analyzed. The primary outcome was a 1-month favorable neurological outcome. Logistic regression analysis was performed to estimate the influence of cardiopulmonary resuscitation duration. The CPR duration that achieved a cumulative proportion >99% of cases with a 1-month neurologically favorable outcome was determined. Results: Of the 3,353 eligible cases, pre-hospital return of spontaneous circulation was obtained in 1,692 cases (50.5%). A total of 279 (8.3%) cases had a 1-month neurologically favorable outcome. The CPR duration was significantly and inversely associated with 1-month neurologically favorable outcomes with adjustment for pre- and in-hospital confounders (adjusted odds ratio: 0.911, per minute, 95% CI: 0.892-0.929, p < 0.001). After 30min of CPR, the probability of a 1-month neurologically favorable outcome decreased from 8.3 to 0.7%. At 45min of CPR, the cumulative proportion for a 1-month neurologically favorable outcome reached >99%. Conclusions: The CPR duration was independently and inversely associated with 1-month neurologically favorable outcomes after out-of-hospital cardiac arrest. The CPR duration required to achieve return of spontaneous circulation in >99% of out-of-hospital cardiac arrest patients with a 1-month favorable neurological outcome was 45min, considering both pre- and in-hospital settings.

KW - Cardiopulmonary resuscitation

KW - Emergency medical services

KW - Out-of-hospital cardiac arrest

KW - Patient outcome assessment

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U2 - 10.1186/s12871-017-0351-1

DO - 10.1186/s12871-017-0351-1

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AN - SCOPUS:85018526530

VL - 17

JO - BMC Anesthesiology

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