Actual treatments for out‐of‐hospital ventricular fibrillation at critical care medical centers in <scp>O</scp>saka: a pilot descriptive study

Sakai, Tomohiko; Kitamura, Tetsuhisa; Iwami, Taku; Hayashi, Yasuyuki; Rinka, Hiroshi; Ohishi, Yasuo; Mohri, Tomoyoshi; Kishimoto, Masafumi; Kawaguchi, Ryosuke; Kajino, Kentaro; Yumoto, Tetsuya; Uejima, Tokuhisa; Nitta, Masahiko; Nishiuchi, Tatsuya; Shiokawa, Chizuka; Irisawa, Taro; Tasaki, Osamu; Ogura, Hiroshi; Kuwagata, Yasuyuki; Shimazu, Takeshi

doi:10.1002/ams2.27

Cited by 2 publications

(3 citation statements)

References 30 publications

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“…The κ value measuring interrater reliability was 0.75 when reviewing the title and abstracts and 0.9 for full‐text review. Finally, 36 studies 20 , 23 , 24 , 25 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 qualified for analysis. The study selection process and reasons for excluding the 54 studies are illustrated in the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses‐P 2020 flow diagram (Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 147 943 patients were included in the 36 studies. Two studies 55 , 67 were conducted in Australia, 1 in Canada 66 , 1 in the Czech Republic, 60 2 in Denmark, 47 , 53 1 in France, 56 5 in Japan, 24 , 44 , 50 , 58 , 64 8 in South Korea, 40 , 42 , 46 , 48 , 49 , 51 , 62 , 63 1 in Norway, 37 4 in Taiwan, 23 , 45 , 65 , 68 2 in the United Kingdom, 20 , 59 and 9 § in the United States. Three articles reported data from the CARES (Cardiac Arrest Registry to Enhance Survival) registry, 2 articles from the CAVAS database (Cardiovascular Disease Surveillance), 2 articles from the NHIRD database (National Health Insurance Research), and 3 articles from the UOP (Utstein Osaka Project).…”

Section: Resultsmentioning

confidence: 99%

“…Subgroup analysis comparing patients with initial shockable or nonshockable rhythm (Figure 4 ) 23 , 25 , 44 , 50 , 65 revealed a significant increase in survival with good neurological outcome among patients with both shockable (OR, 2.31 [95% CI, 1.77–3.02]) and nonshockable rhythm (OR, 1.16 [95% CI, 0.73–1.84]) when treated at CACs. The treatment effect was significantly greater among patients with initial shockable compared with nonshockable rhythm ( P =0.006).…”

Section: Resultsmentioning

confidence: 99%

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Impact of Cardiac Arrest Centers on the Survival of Patients With Nontraumatic Out‐of‐Hospital Cardiac Arrest: A Systematic Review and Meta‐Analysis

Yeo

Goh

et al. 2022

JAHA

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Background The role of cardiac arrest centers (CACs) in out‐of‐hospital cardiac arrest care systems is continuously evolving. Interpretation of existing literature is limited by heterogeneity in CAC characteristics and types of patients transported to CACs. This study assesses the impact of CACs on survival in out‐of‐hospital cardiac arrest according to varying definitions of CAC and prespecified subgroups. Methods and Results Electronic databases were searched from inception to March 9, 2021 for relevant studies. Centers were considered CACs if self‐declared by study authors and capable of relevant interventions. Main outcomes were survival and neurologically favorable survival at hospital discharge or 30 days. Meta‐analyses were performed for adjusted odds ratio (aOR) and crude odds ratios. Thirty‐six studies were analyzed. Survival with favorable neurological outcome significantly improved with treatment at CACs (aOR, 1.85 [95% CI, 1.52–2.26]), even when including high‐volume centers (aOR, 1.50 [95% CI, 1.18–1.91]) or including improved‐care centers (aOR, 2.13 [95% CI, 1.75–2.59]) as CACs. Survival significantly increased with treatment at CACs (aOR, 1.92 [95% CI, 1.59–2.32]), even when including high‐volume centers (aOR, 1.74 [95% CI, 1.38–2.18]) or when including improved‐care centers (aOR, 1.97 [95% CI, 1.71–2.26]) as CACs. The treatment effect was more pronounced among patients with shockable rhythm ( P =0.006) and without prehospital return of spontaneous circulation ( P =0.005). Conclusions were robust to sensitivity analyses, with no publication bias detected. Conclusions Care at CACs was associated with improved survival and neurological outcomes for patients with nontraumatic out‐of‐hospital cardiac arrest regardless of varying CAC definitions. Patients with shockable rhythms and those without prehospital return of spontaneous circulation benefited more from CACs. Evidence for bypassing hospitals or interhospital transfer remains inconclusive.

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