Mechanical cardiopulmonary resuscitation and hospital survival among adult patients with nontraumatic out-of-hospital cardiac arrest attending the emergency department

A prospective, multicenter, observational study in Japan (SOS-KANTO [Survey of Survivors after Out-of-Hospital Cardiac Arrest in Kanto Area] 2012 study)

on behalf of the SOS-KANTO Study Group

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background--Mechanical cardiopulmonary resuscitation (mCPR) for patients with out-of-hospital cardiac arrest attending the emergency department has become more widespread in Japan. The objective of this study is to determine the association between the mCPR in the emergency department and clinical outcomes. Methods and Results--In a prospective, multicenter, observational study, adult patients with out-of-hospital cardiac arrest with sustained circulatory arrest on hospital arrival were identified. The primary outcome was survival to hospital discharge. The secondary outcomes included a return of spontaneous circulation and successful hospital admission. Multivariate analyses adjusted for potential confounders and within-institution clustering effects using a generalized estimation equation were used to analyze the association of the mCPR with outcomes. Between January 1, 2012 and March 31, 2013, 6537 patients with out-of-hospital cardiac arrest were eligible; this included 5619 patients (86.0%) in the manual CPR group and 918 patients (14.0%) in the mCPR group. Of those patients, 28.1% (1801/ 6419) showed return of spontaneous circulation in the emergency department, 20.4% (1175/5754) had hospital admission, 2.6% (168/ 6504) survived to hospital discharge, and 1.2% (75/6419) showed a favorable neurological outcome at 1 month after admission. Multivariate analyses revealed that mCPR was associated with a decreased likelihood of survival to hospital discharge (adjusted odds ratio, 0.40; 95% confidence interval, 0.20-0.78; P=0.005), return of spontaneous circulation (adjusted odds ratio, 0.71; 95% confidence interval, 0.53-0.94; P=0.018), and hospital admission (adjusted odds ratio, 0.57; 95% confidence interval, 0.40-0.80; P=0.001). Conclusions--After accounting for potential confounders, the mCPR in the emergency department was associated with decreased likelihoods of good clinical outcomes after adult nontraumatic out-of-hospital cardiac arrest. Further studies are needed to clarify circumstances in which mCPR may benefit these patients.

Original languageEnglish
Article numbere007420
JournalJournal of the American Heart Association
Volume6
Issue number11
DOIs
Publication statusPublished - 2017 Nov 1

Fingerprint

Out-of-Hospital Cardiac Arrest
Cardiopulmonary Resuscitation
Multicenter Studies
Observational Studies
Survivors
Hospital Emergency Service
Japan
Survival
Odds Ratio
Confidence Intervals
Multivariate Analysis
Surveys and Questionnaires
Cluster Analysis

Keywords

  • Cardiopulmonary resuscitation
  • Emergency department
  • Mechanical chest compression device

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{6ea75e143a1b44f89e46d3cfd1697527,
title = "Mechanical cardiopulmonary resuscitation and hospital survival among adult patients with nontraumatic out-of-hospital cardiac arrest attending the emergency department: A prospective, multicenter, observational study in Japan (SOS-KANTO [Survey of Survivors after Out-of-Hospital Cardiac Arrest in Kanto Area] 2012 study)",
abstract = "Background--Mechanical cardiopulmonary resuscitation (mCPR) for patients with out-of-hospital cardiac arrest attending the emergency department has become more widespread in Japan. The objective of this study is to determine the association between the mCPR in the emergency department and clinical outcomes. Methods and Results--In a prospective, multicenter, observational study, adult patients with out-of-hospital cardiac arrest with sustained circulatory arrest on hospital arrival were identified. The primary outcome was survival to hospital discharge. The secondary outcomes included a return of spontaneous circulation and successful hospital admission. Multivariate analyses adjusted for potential confounders and within-institution clustering effects using a generalized estimation equation were used to analyze the association of the mCPR with outcomes. Between January 1, 2012 and March 31, 2013, 6537 patients with out-of-hospital cardiac arrest were eligible; this included 5619 patients (86.0{\%}) in the manual CPR group and 918 patients (14.0{\%}) in the mCPR group. Of those patients, 28.1{\%} (1801/ 6419) showed return of spontaneous circulation in the emergency department, 20.4{\%} (1175/5754) had hospital admission, 2.6{\%} (168/ 6504) survived to hospital discharge, and 1.2{\%} (75/6419) showed a favorable neurological outcome at 1 month after admission. Multivariate analyses revealed that mCPR was associated with a decreased likelihood of survival to hospital discharge (adjusted odds ratio, 0.40; 95{\%} confidence interval, 0.20-0.78; P=0.005), return of spontaneous circulation (adjusted odds ratio, 0.71; 95{\%} confidence interval, 0.53-0.94; P=0.018), and hospital admission (adjusted odds ratio, 0.57; 95{\%} confidence interval, 0.40-0.80; P=0.001). Conclusions--After accounting for potential confounders, the mCPR in the emergency department was associated with decreased likelihoods of good clinical outcomes after adult nontraumatic out-of-hospital cardiac arrest. Further studies are needed to clarify circumstances in which mCPR may benefit these patients.",
keywords = "Cardiopulmonary resuscitation, Emergency department, Mechanical chest compression device",
author = "{on behalf of the SOS-KANTO Study Group} and Kei Hayashida and Takashi Tagami and Tatsuma Fukuda and Masaru Suzuki and Naohiro Yonemoto and Yutaka Kondo and Tomoko Ogasawara and Atsushi Sakurai and Yoshio Tahara and Ken Nagao and Arino Yaguchi and Naoto Morimura 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 Nobuya Kitamura and Shigeto Oda and Kenji Kobayashi and Takayuki Suda and Kazuyuki Ono and Ryosuke Furuya and Yuichi Koido and Fumiaki Iwase and Shigeru Kanesaka and Yasusei Okada and Kyoko Unemoto and Tomohito Sadahiro and Masayuki Iyanaga and Asaki Muraoka and Munehiro Hayashi and Shinichi Ishimatsu and Yasufumi Miyake and Hideo Yokokawa and Yasuaki Koyama and Asuka Tsuchiya and Tetsuya Kashiyama and Kiyohiro Oshima and Kazuya Kiyota and Yuichi Hamabe and Hiroyuki Yokota and Shingo Hori and Shin Inaba and Tetsuya Sakamoto",
year = "2017",
month = "11",
day = "1",
doi = "10.1161/JAHA.117.007420",
language = "English",
volume = "6",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "11",

}

TY - JOUR

T1 - Mechanical cardiopulmonary resuscitation and hospital survival among adult patients with nontraumatic out-of-hospital cardiac arrest attending the emergency department

T2 - A prospective, multicenter, observational study in Japan (SOS-KANTO [Survey of Survivors after Out-of-Hospital Cardiac Arrest in Kanto Area] 2012 study)

AU - on behalf of the SOS-KANTO Study Group

AU - Hayashida, Kei

AU - Tagami, Takashi

AU - Fukuda, Tatsuma

AU - Suzuki, Masaru

AU - Yonemoto, Naohiro

AU - Kondo, Yutaka

AU - Ogasawara, Tomoko

AU - Sakurai, Atsushi

AU - Tahara, Yoshio

AU - Nagao, Ken

AU - Yaguchi, Arino

AU - Morimura, Naoto

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 - Kitamura, Nobuya

AU - Oda, Shigeto

AU - Kobayashi, Kenji

AU - Suda, Takayuki

AU - Ono, Kazuyuki

AU - Furuya, Ryosuke

AU - Koido, Yuichi

AU - Iwase, Fumiaki

AU - Kanesaka, Shigeru

AU - Okada, Yasusei

AU - Unemoto, Kyoko

AU - Sadahiro, Tomohito

AU - Iyanaga, Masayuki

AU - Muraoka, Asaki

AU - Hayashi, Munehiro

AU - Ishimatsu, Shinichi

AU - Miyake, Yasufumi

AU - Yokokawa, Hideo

AU - Koyama, Yasuaki

AU - Tsuchiya, Asuka

AU - Kashiyama, Tetsuya

AU - Oshima, Kiyohiro

AU - Kiyota, Kazuya

AU - Hamabe, Yuichi

AU - Yokota, Hiroyuki

AU - Hori, Shingo

AU - Inaba, Shin

AU - Sakamoto, Tetsuya

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background--Mechanical cardiopulmonary resuscitation (mCPR) for patients with out-of-hospital cardiac arrest attending the emergency department has become more widespread in Japan. The objective of this study is to determine the association between the mCPR in the emergency department and clinical outcomes. Methods and Results--In a prospective, multicenter, observational study, adult patients with out-of-hospital cardiac arrest with sustained circulatory arrest on hospital arrival were identified. The primary outcome was survival to hospital discharge. The secondary outcomes included a return of spontaneous circulation and successful hospital admission. Multivariate analyses adjusted for potential confounders and within-institution clustering effects using a generalized estimation equation were used to analyze the association of the mCPR with outcomes. Between January 1, 2012 and March 31, 2013, 6537 patients with out-of-hospital cardiac arrest were eligible; this included 5619 patients (86.0%) in the manual CPR group and 918 patients (14.0%) in the mCPR group. Of those patients, 28.1% (1801/ 6419) showed return of spontaneous circulation in the emergency department, 20.4% (1175/5754) had hospital admission, 2.6% (168/ 6504) survived to hospital discharge, and 1.2% (75/6419) showed a favorable neurological outcome at 1 month after admission. Multivariate analyses revealed that mCPR was associated with a decreased likelihood of survival to hospital discharge (adjusted odds ratio, 0.40; 95% confidence interval, 0.20-0.78; P=0.005), return of spontaneous circulation (adjusted odds ratio, 0.71; 95% confidence interval, 0.53-0.94; P=0.018), and hospital admission (adjusted odds ratio, 0.57; 95% confidence interval, 0.40-0.80; P=0.001). Conclusions--After accounting for potential confounders, the mCPR in the emergency department was associated with decreased likelihoods of good clinical outcomes after adult nontraumatic out-of-hospital cardiac arrest. Further studies are needed to clarify circumstances in which mCPR may benefit these patients.

AB - Background--Mechanical cardiopulmonary resuscitation (mCPR) for patients with out-of-hospital cardiac arrest attending the emergency department has become more widespread in Japan. The objective of this study is to determine the association between the mCPR in the emergency department and clinical outcomes. Methods and Results--In a prospective, multicenter, observational study, adult patients with out-of-hospital cardiac arrest with sustained circulatory arrest on hospital arrival were identified. The primary outcome was survival to hospital discharge. The secondary outcomes included a return of spontaneous circulation and successful hospital admission. Multivariate analyses adjusted for potential confounders and within-institution clustering effects using a generalized estimation equation were used to analyze the association of the mCPR with outcomes. Between January 1, 2012 and March 31, 2013, 6537 patients with out-of-hospital cardiac arrest were eligible; this included 5619 patients (86.0%) in the manual CPR group and 918 patients (14.0%) in the mCPR group. Of those patients, 28.1% (1801/ 6419) showed return of spontaneous circulation in the emergency department, 20.4% (1175/5754) had hospital admission, 2.6% (168/ 6504) survived to hospital discharge, and 1.2% (75/6419) showed a favorable neurological outcome at 1 month after admission. Multivariate analyses revealed that mCPR was associated with a decreased likelihood of survival to hospital discharge (adjusted odds ratio, 0.40; 95% confidence interval, 0.20-0.78; P=0.005), return of spontaneous circulation (adjusted odds ratio, 0.71; 95% confidence interval, 0.53-0.94; P=0.018), and hospital admission (adjusted odds ratio, 0.57; 95% confidence interval, 0.40-0.80; P=0.001). Conclusions--After accounting for potential confounders, the mCPR in the emergency department was associated with decreased likelihoods of good clinical outcomes after adult nontraumatic out-of-hospital cardiac arrest. Further studies are needed to clarify circumstances in which mCPR may benefit these patients.

KW - Cardiopulmonary resuscitation

KW - Emergency department

KW - Mechanical chest compression device

UR - http://www.scopus.com/inward/record.url?scp=85034757425&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85034757425&partnerID=8YFLogxK

U2 - 10.1161/JAHA.117.007420

DO - 10.1161/JAHA.117.007420

M3 - Article

VL - 6

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 11

M1 - e007420

ER -