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Title: Temporal trends in out-of-hospital cardiac arrest survival outcomes between two metropolitan communities: Seoul-Osaka resuscitation study.
Authors: Ro, Young Sun
Shin, Sang Do
Kitamura, Tetsuhisa
Lee, Eui Jung
Kajino, Kentaro
Song, Kyoung Jun
Nishiyama, Chika  kyouindb  KAKEN_id
Kong, So Yeon
Sakai, Tomohiko
Nishiuchi, Tatsuya
Hayashi, Yasuyuki
Iwami, Taku  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-4150-7065 (unconfirmed)
Author's alias: 石見, 拓
Issue Date: 9-Jun-2015
Publisher: BMJ Publishing Group
Journal title: BMJ open
Volume: 5
Issue: 6
Thesis number: e007626
Abstract: [Objectives] The objective of this study was to compare the temporal trends in survival after out-of-hospital cardiac arrest (OHCA) between two large metropolitan communities in Asia and evaluate the factors affecting survival after OHCA. [Design] A population-based prospective observational study. [Setting] The Cardiovascular Disease Surveillance (CAVAS) project in Seoul and the Utstein Osaka Project in Osaka. [Participants] A total of 36 292 resuscitation-attempted OHCAs with cardiac aetiology from 2006 to 2011 in Seoul and Osaka (11 082 in Seoul and 25 210 in Osaka). [Primary outcome measures] The primary outcome was neurologically favourable survival. Trend analysis and multivariable Poisson regression models were conducted to evaluate the temporal trends in survival of two communities. [Results] During the study period, the overall neurologically favourable survival was 2.6% in Seoul and 4.6% in Osaka (p<0.01). In both communities, bystander cardiopulmonary resuscitation (CPR) rates increased significantly from 2006 to 2011 (from 0.1% to 13.1% in Seoul and from 33.3% to 41.7% in Osaka). OHCAs that occurred in public places increased in Seoul (12.5% to 20.1%, p for trend <0.01) and decreased in Osaka (13.5% to 10.5%, p for trend <0.01). The proportion of OHCAs defibrillated by emergency medical service (EMS) providers was only 0.4% in 2006 but increased to 17.5% in 2011 in Seoul, whereas the proportion in Osaka decreased from 17.7% to 13.7% (both p for trend <0.01). Age-adjusted and gender-adjusted rates of neurologically favourable survival increased significantly in Seoul from 1.4% in 2006 to 4.3% in 2011 (adjusted rate ratio per year, 1.17; p for trend <0.01), whereas no significant improvement was observed in Osaka (3.6% in 2006 and 5.1% in 2011; adjusted rate ratio per year, 1.03; p for trend=0.08). [Conclusions] Survivals after OHCA were increased in Seoul while remained constant in Osaka, which may have been affected by the differences and improvements of patient, community, and EMS system factors.
Rights: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
URI: http://hdl.handle.net/2433/201988
DOI(Published Version): 10.1136/bmjopen-2015-007626
PubMed ID: 26059524
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