Trends in In-Hospital Advanced Management and Survival of Out-of-Hospital Cardiac Arrest Among Adults From 2013 to 2017　― A Multicenter, Prospective Registry in Osaka, Japan

• Published in: Circulation Journal Vol. 85; no. 10; pp. 1851 - 1859
• Main Authors: Yoshimura, Satoshi, Hirayama, Atsushi, Kiguchi, Takeyuki, Irisawa, Taro, Yamada, Tomoki, Yoshiya, Kazuhisa, Park, Changhwi, Nishimura, Tetsuro, Ishibe, Takuya, Yagi, Yoshiki, Kishimoto, Masafumi, Inoue, Toshiya, Hayashi, Yasuyuki, Sogabe, Taku, Morooka, Takaya, Sakamoto, Haruko, Suzuki, Keitaro, Nakamura, Fumiko, Matsuyama, Tasuku, Okada, Yohei, Nishioka, Norihiro, Kobayashi, Daisuke, Matsui, Satoshi, Kimata, Shunsuke, Shimazu, Takeshi, Kitamura, Tetsuhisa, Iwami, Taku, on behalf of the CRITICAL Study Group Investigators
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 24.09.2021
• Subjects: Adolescent; Adult; Cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - methods; Hospitals; Humans; Japan - epidemiology; Out-of-hospital cardiac arrest; Out-of-Hospital Cardiac Arrest - therapy; Patient management; Prospective Studies; Registries; Survival trend; Japan; Out-of-hospital cardiac arrest; Survival trend; Patient management; Cardiopulmonary resuscitation
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-20-1022

Background:The aim of our study was to investigate in detail the temporal trends in in-hospital characteristics, actual management, and survival, including neurological status, among adult out-of-hospital cardiac arrest (OHCA) patients in recent years.Methods and Results:From the prospective database of the Comprehensive Registry of Intensive Care for OHCA Survival (CRITICAL) study in Osaka, Japan, we enrolled all OHCA patients aged ≥18 years for whom resuscitation was attempted, and who were transported to participating hospitals between the years 2013 and 2017. The primary outcome measure was 1-month survival with favorable neurological outcome after OHCA. Temporal trends in in-hospital management and favorable neurological outcome among adult OHCA patients were assessed. Of the 11,924 patients in the database, we included a total of 10,228 adult patients from 16 hospitals. As for in-hospital advanced treatments, extracorporeal cardiopulmonary resuscitation (ECPR) use increased from 2.4% in 2013 to 4.3% in 2017 (P for trend <0.001). However, the proportion of adult OHCA patients with favorable neurological outcome did not change during the study period (from 5.7% in 2013 to 4.4% in 2017, adjusted odds ratio (OR) for 1-year increment: 0.98 (95% confidence interval: 0.94–1.23)).Conclusions:In this target population, in-hospital management such as ECPR increased slightly between 2013 and 2017, but 1-month survival with favorable neurological outcome after adult OHCA did not improve significantly.