Relationship Between the Duration of Cardiopulmonary Resuscitation and Favorable Neurological Outcomes After Out‐of‐Hospital Cardiac Arrest: A Prospective, Nationwide, Population‐Based Cohort Study

Goto, Yoshikazu; Funada, Akira; Goto, Yumiko

doi:10.1161/jaha.115.002819

Cited by 137 publications

(121 citation statements)

References 33 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…The longest duration of CPR with a patient that survived with a good neurological outcome was 47 minutes (Reynolds et al, 2016). Similar results were also found in large observational studies performed in Japan (Goto, Funada, & Goto, 2016;Nagao et al, 2016).…”

Section: When Should a First-aid Provider Stop Cprsupporting

confidence: 90%

When Should a First-Aid Provider Stop CPR: Answer from the American Red Cross Scientific Advisory Council

Jones¹,

Bradley²

2017

IJFAE

View full text Add to dashboard Cite

Section: When Should a First-aid Provider Stop Cprsupporting

confidence: 90%

When Should a First-Aid Provider Stop CPR: Answer from the American Red Cross Scientific Advisory Council

Jones¹,

Bradley²

2017

IJFAE

View full text Add to dashboard Cite

“…In 2005, the FDMA launched an ongoing, prospective, population‐based, observational study involving all patients with OHCA who received resuscitation by EMS personnel in Japan 12, 15. Since 2005, with the cooperation of the physician in charge, EMS personnel at each center recorded data from patients with OHCA using an Utstein‐style template 16, 17.…”

Section: Methodsmentioning

confidence: 99%

Relationship Between Emergency Medical Services Response Time and Bystander Intervention in Patients With Out‐of‐Hospital Cardiac Arrest

Goto

Funada

Goto

2018

JAHA

Self Cite

View full text Add to dashboard Cite

BackgroundThe response time of emergency medical services (EMS) is an important determinant of survival after out‐of‐hospital cardiac arrest. We sought to identify upper limits of EMS response times and bystander interventions associated with neurologically intact survival.Methods and ResultsWe analyzed the records of 553 426 patients with out‐of‐hospital cardiac arrest in a Japanese registry between 2010 and 2014. The primary study end point was 1‐month neurologically intact survival (Cerebral Performance Category scale 1 or 2). Increased EMS response time was associated with significantly decreased adjusted odds of 1‐month neurologically intact survival (adjusted odds ratio [aOR] for each 1‐minute increase, 0.89; 95% confidence interval [CI], 0.89–0.90), although this relationship was modified by bystander interventions. The bystander interventions and the ranges of EMS response times that were associated with increased adjusted 1‐month neurologically intact survival were as follows: bystander defibrillation, from ≤2 minutes (aOR, 3.10 [95% CI, 1.25–7.31]) to 13 minutes (aOR, 5.55 [95% CI, 2.66–11.2]); bystander conventional cardiopulmonary resuscitation, from 3 minutes (aOR 1.48 [95% CI, 1.02–2.12]) to 11 minutes (aOR 2.41 [95% CI, 1.61–3.56]); and bystander chest‐compression‐only cardiopulmonary resuscitation, from ≤2 minutes (aOR 1.57 [95% CI, 1.01–2.25]) to 11 minutes (aOR 1.92 [95% CI, 1.45–2.56]). However, the increase in neurologically intact survival of those receiving bystander interventions became statistically insignificant compared with no bystander interventions when the EMS response time was outside these ranges.ConclusionsThe upper limits of the EMS response times associated with improved 1‐month neurologically intact survival were 13 minutes when bystanders provided defibrillation (typically with cardiopulmonary resuscitation) and 11 minutes when bystanders provided cardiopulmonary resuscitation without defibrillation.

show abstract

“…1- 4 Recently, several studies have investigated the relationship between CPR duration and outcome, and in particular according to initial documented rhythm. [5][6][7][8][9][10][11] crew consists of 3 EMS staff members, including at least 1 emergency lifesaving technician (ELST). ELSTs are allowed to use various resuscitation methods, including for whom resuscitation was attempted after OHCA in Japan between January 2011 and December 2014.…”

Section: Study Design and Data Sourcementioning

confidence: 99%

“…Some data from this patient cohort from January 2011 to December 2012 have been reported as part of other analyses investigating the relationship between CPR duration and initial documented rhythm. 6 Cardiac arrest was defined as the cessation of cardiac mechanical activity as confirmed by the absence of signs of circulation. The cause of arrest was presumed to be cardiac unless evidence suggested an external cause, respiratory disease, cerebrovascular disease, malignant tumor, or any other noncardiac cause.…”

Section: Study Design and Data Sourcementioning

confidence: 99%

Age-Specific Differences in the Duration of Prehospital Cardiopulmonary Resuscitation Administered by Emergency Medical Service Providers Necessary to Achieve Favorable Neurological Outcome After Out-of-Hospital Cardiac Arrest

Funada

Goto

Tada

et al. 2017

Circ J

Self Cite

View full text Add to dashboard Cite

Background:The appropriate duration of prehospital cardiopulmonary resuscitation (CPR) administered by emergency medical service (EMS) providers for patients with out-of-hospital cardiac arrest (OHCA) necessary to achieve 1-month survival with favorable neurological outcome (Cerebral Performance Category 1 or 2, CPC 1-2) is unclear and could differ by age. Methods and Results:We analyzed the records of 35,709 adult OHCA patients with return of spontaneous circulation (ROSC) before hospital arrival in a prospectively recorded Japanese registry between 2011 and 2014. The CPR duration was defined as the time from CPR initiation by EMS providers to prehospital ROSC. The rate of 1-month CPC 1-2 was 21.4% (7,650/35,709). The CPR duration was independently and inversely associated with 1-month CPC 1-2 (adjusted odds ratio, 0.93 per 1-min increment; 95% confidence interval, 0.93-0.94). The CPR duration increased with age (P<0.001). However, the CPR duration beyond which the proportion of OHCA patients with 1-month CPC 1-2 decreased to <1% declined with age: 28 min for patients aged 18-64 years, 25 min for 65-74 years, 23 min for 75-84 years, 20 min for 85-94 years, and 18 min for ≥95 years. Conclusions:In patients who achieved prehospital ROSC after OHCA, the duration of CPR administered by EMS providers necessary to achieve 1-month CPC 1-2 varied by age.Key Words: Aging; Cardiopulmonary resuscitation; Epidemiology; Out-of-hospital cardiac arrest ORIGINAL ARTICLE Arrhythmia/ElectrophysiologyCirculation Journal Vol.81, May 2017 653 CPR Duration and Outcomes After OHCA by Age crew consists of 3 EMS staff members, including at least 1 emergency lifesaving technician (ELST). ELSTs are allowed to use various resuscitation methods, including for whom resuscitation was attempted after OHCA in Japan between January 2011 and December 2014. Some data from this patient cohort from January 2011 to December 2012 have been reported as part of other analyses investigating the relationship between CPR duration and initial documented rhythm. 6 Cardiac arrest was defined as the cessation of cardiac mechanical activity as confirmed by the absence of signs of circulation. The cause of arrest was presumed to be cardiac unless evidence suggested an external cause, respiratory disease, cerebrovascular disease, malignant tumor, or any other noncardiac cause. Physicians in charge made the determination of the cause of arrest in collaboration with EMS providers.This study was approved by the Ethics Committee of Kanazawa University with a waiver of informed consent because of the anonymous nature of the data. The Japanese EMS SystemJapan has approximately 127 million residents in an area of 378,000 km 2 . Details of the Japanese EMS system have been described previously. 13 The FDMA of Japan supervises the national EMS system. Each local EMS system is operated by the local fire station. In general, an ambulance whether ROSC was achieved before arrival at the hospital, time of the emergency call, time of vehicle arrival at the scene, time of CPR ...

show abstract

Relationship Between the Duration of Cardiopulmonary Resuscitation and Favorable Neurological Outcomes After Out‐of‐Hospital Cardiac Arrest: A Prospective, Nationwide, Population‐Based Cohort Study

Cited by 137 publications

References 33 publications

When Should a First-Aid Provider Stop CPR: Answer from the American Red Cross Scientific Advisory Council

When Should a First-Aid Provider Stop CPR: Answer from the American Red Cross Scientific Advisory Council

Relationship Between Emergency Medical Services Response Time and Bystander Intervention in Patients With Out‐of‐Hospital Cardiac Arrest

Age-Specific Differences in the Duration of Prehospital Cardiopulmonary Resuscitation Administered by Emergency Medical Service Providers Necessary to Achieve Favorable Neurological Outcome After Out-of-Hospital Cardiac Arrest

Contact Info

Product

Resources

About