The response time threshold for predicting favourable neurological outcomes in patients with bystander-witnessed out-of-hospital cardiac arrest

Ono, Yuichi; Hayakawa, Mineji; Iijima, Hiroaki; Maekawa, Kunihiko; Kodate, Akira; Sadamoto, Yoshihiro; Mizugaki, Asumi; Murakami, Hiromoto; Katabami, Kenichi; Sawamura, Atsushi; Gando, Satoshi

The response time threshold for predicting favourable neurological outcomes in patients with bystander-witnessed out-of-hospital cardiac arrest

Ono, Yuichi; Hayakawa, Mineji; Iijima, Hiroaki et al.

Resuscitation, 2016, 107, 65-70

Permalink : https://hdl.handle.net/2115/67233

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アクセス権	open access
URI	https://hdl.handle.net/2115/67233
タイトル	The response time threshold for predicting favourable neurological outcomes in patients with bystander-witnessed out-of-hospital cardiac arrest
著者	Ono, Yuichi ; Hayakawa, Mineji ; Iijima, Hiroaki ; Maekawa, Kunihiko ; Kodate, Akira ; Sadamoto, Yoshihiro ; Mizugaki, Asumi ; Murakami, Hiromoto ; Katabami, Kenichi ; Sawamura, Atsushi ; Gando, Satoshi
著者名 Ono, Yuichi
e-Rad_Researcher 10374282 著者名 Hayakawa, Mineji
著者名 Iijima, Hiroaki
著者名 Maekawa, Kunihiko
著者名 Kodate, Akira
著者名 Sadamoto, Yoshihiro
著者名 Mizugaki, Asumi
著者名 Murakami, Hiromoto
著者名 Katabami, Kenichi
e-Rad_Researcher 00241448 著者名 Sawamura, Atsushi
e-Rad_Researcher 30125306 著者名 Gando, Satoshi
言語	英語
キーワード	Out of hospital cardiac arrest
	Neurological outcome
	Response time
発行日	2016-10
出版者	Elsevier
収録物名	Resuscitation
巻(号)	107
ページ	65-70
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
権利情報	© 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/
PISSN	0300-9572
関連情報	PMID 27531022
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/j.resuscitation.2016.08.005