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The response time threshold for predicting favourable neurological outcomes in patients with bystander-witnessed out-of-hospital cardiac arrest
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| Title: | The response time threshold for predicting favourable neurological outcomes in patients with bystander-witnessed out-of-hospital cardiac arrest |
| Authors: | Ono, Yuichi Browse this author | | Hayakawa, Mineji Browse this author →KAKEN DB | | Iijima, Hiroaki Browse this author | | Maekawa, Kunihiko Browse this author | | Kodate, Akira Browse this author | | Sadamoto, Yoshihiro Browse this author | | Mizugaki, Asumi Browse this author | | Murakami, Hiromoto Browse this author | | Katabami, Kenichi Browse this author | | Sawamura, Atsushi Browse this author →KAKEN DB | | Gando, Satoshi Browse this author →KAKEN DB |
| Keywords: | Out of hospital cardiac arrest | | Neurological outcome | | Response time |
| Issue Date: | Oct-2016 |
| Publisher: | Elsevier |
| Journal Title: | Resuscitation |
| Volume: | 107 |
| Start Page: | 65 |
| End Page: | 70 |
| Publisher DOI: | 10.1016/j.resuscitation.2016.08.005 |
| PMID: | 27531022 |
| Abstract: | Objective: It is well established that the period of time between a call being made to emergency medical services (EMS) and the time at which EMS arrive at the scene (i.e., the response time) affects survival outcomes in patients who experienced out-of-hospital cardiac arrest (OHCA). However, the relationship between response time and favourable neurological outcomes remains unclear. We therefore aimed to determine a response time threshold in bystander-witnessed OHCA patients that is associated with positive neurological outcomes and to assess the relationship between response time and neurological outcomes in OHCA patients. Methods: This study was a retrospective, observational analysis of data from 204,277 episodes of bystander-witnessed OHCA between 2006 and 2012 in Japan. We used classification and regression trees (CARTs) and receiver operating characteristic (ROC) curve analysis to determine the threshold of response time associated with favourable neurological outcomes (Cerebral Performance Category 1 or 2) one month after cardiac arrest. Results: Both CARTs and ROC analyses indicated that a threshold of 6.5 min was associated with improved neurological outcomes in all bystander-witnessed OHCA events from cardiac origin. Furthermore, bystander cardiopulmonary resuscitation (CPR) prolonged the threshold of response time by 1 min (to 7.5 min). The adjusted odds ratios for favorable neurological outcomes in OHCA patients who received care within ≤ 6.5 min was 1.935 (95% confidential interval: 1.834-2.041, P<0.001). Conclusions: A response time ≤ 6.5 min was closely associated with favourable neurological outcomes in all bystander-witnessed OHCA patients. Bystander CPR prolonged the response time threshold by 1 min. |
| Rights: | © 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ | | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/67233 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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Submitter: 早川 峰司
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