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タイトル: | Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: a prospective cohort study |
著者: | Kashiura, Masahiro Hamabe, Yuichi Akashi, Akiko Sakurai, Atsushi Tahara, Yoshio Yonemoto, Naohiro Nagao, Ken Yaguchi, Arino Morimura, Naoto |
著者名の別形: | 米本, 直裕 |
キーワード: | Cardiopulmonary resuscitation Emergency medical services Out-of-hospital cardiac arrest Patient outcome assessment |
発行日: | 21-Apr-2017 |
出版者: | Springer Nature |
誌名: | BMC Anesthesiology |
巻: | 17 |
論文番号: | 59 |
抄録: | [Background]The duration of cardiopulmonary resuscitation (CPR) is an important factor associated with the outcomes for an out-of-hospital cardiac arrest. However, the appropriate CPR duration remains unclear considering pre- and in-hospital settings. The present study aimed to evaluate the relationship between the CPR duration (including both the pre- and in-hospital duration) and neurologically favorable outcomes 1-month after cardiac arrest. [Methods] Data were utilized from a prospective multi-center cohort study of out-of-hospital cardiac arrest patients transported to 67 emergency hospitals between January 2012 and March 2013 in the Kanto area of Japan. A total of 3, 353 patients with out-of-hospital cardiac arrest (age ≥18 years) who underwent CPR by emergency medical service personnel and achieved the return of spontaneous circulation in a pre- or in-hospital setting were analyzed. The primary outcome was a 1-month favorable neurological outcome. Logistic regression analysis was performed to estimate the influence of cardiopulmonary resuscitation duration. The CPR duration that achieved a cumulative proportion >99% of cases with a 1-month neurologically favorable outcome was determined. [Results] Of the 3, 353 eligible cases, pre-hospital return of spontaneous circulation was obtained in 1, 692 cases (50.5%). A total of 279 (8.3%) cases had a 1-month neurologically favorable outcome. The CPR duration was significantly and inversely associated with 1-month neurologically favorable outcomes with adjustment for pre- and in-hospital confounders (adjusted odds ratio: 0.911, per minute, 95% CI: 0.892–0.929, p < 0.001). After 30 min of CPR, the probability of a 1-month neurologically favorable outcome decreased from 8.3 to 0.7%. At 45 min of CPR, the cumulative proportion for a 1-month neurologically favorable outcome reached >99%. [Conclusions] The CPR duration was independently and inversely associated with 1-month neurologically favorable outcomes after out-of-hospital cardiac arrest. The CPR duration required to achieve return of spontaneous circulation in >99% of out-of-hospital cardiac arrest patients with a 1-month favorable neurological outcome was 45 min, considering both pre- and in-hospital settings. |
著作権等: | © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
URI: | http://hdl.handle.net/2433/225244 |
DOI(出版社版): | 10.1186/s12871-017-0351-1 |
PubMed ID: | 28431508 |
出現コレクション: | 学術雑誌掲載論文等 |
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