Characteristics and outcomes of out-of-hospital cardiac arrest among students under school supervision in Japan: a descriptive epidemiological study (2008–2021)
Background: A comprehensive understanding of the epidemiology of pediatric out-of-hospital cardiac arrest (OHCA) occurring under school supervision is lacking. We aimed to comprehensively describe the characteristics and outcomes of OHCA among students in elementary schools, junior high schools, hig...
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Komiyama Printing Co. Ltd
2025-01-01
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| Series: | Environmental Health and Preventive Medicine |
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| author | Kosuke Kiyohara Mamoru Ayusawa Masahiko Nitta Takeichiro Sudo Taku Iwami Ken Nakata Yuri Kitamura Tetsuhisa Kitamura |
| author_facet | Kosuke Kiyohara Mamoru Ayusawa Masahiko Nitta Takeichiro Sudo Taku Iwami Ken Nakata Yuri Kitamura Tetsuhisa Kitamura |
| author_sort | Kosuke Kiyohara |
| collection | DOAJ |
| description | Background: A comprehensive understanding of the epidemiology of pediatric out-of-hospital cardiac arrest (OHCA) occurring under school supervision is lacking. We aimed to comprehensively describe the characteristics and outcomes of OHCA among students in elementary schools, junior high schools, high schools, and technical colleges in Japan. Methods: OHCA data from 2008–2021 were obtained from the SPIRITS study, which provides a nationwide database of OHCAs occurring under school supervision across Japan. We included cases in which resuscitation was attempted by emergency medical service personnel or bystanders. The cases were classified into three groups based on their etiology: cardiac, non-cardiac, and traumatic origin. The primary outcome was one-month survival with favorable neurological outcomes, defined as a Glasgow–Pittsburgh cerebral performance category of 1 or 2. The demographic characteristics, event details, and outcomes were compared across the three groups by using χ2 tests for categorical variables and one-way analyses of variance for continuous variables. Results: During the 14-year study period, 602 OHCA cases were confirmed, with 430 (71.4%) classified as cardiac, 91 (15.1%) as non-cardiac, and 81 (13.5%) as traumatic origin. Non-cardiac and traumatic cases were less likely to be witnessed at the time of arrest (46.2% and 42.0%, respectively) than cardiac cases (82.6%; p < 0.001). Initiation of cardiopulmonary resuscitation by bystanders was less common in non-cardiac and traumatic cases (62.6% and 42.0%, respectively) than that in cardiac cases (82.8%; p < 0.001). The delivery of defibrillation using public-access automated external defibrillators was also significantly less frequent in non-cardiac (3.3%) and traumatic cases (6.2%) than that in cardiac cases (59.8%; p < 0.001). Ventricular fibrillation (VF) as the first documented rhythm was observed in 77.9% of cardiac cases but was much less common in non-cardiac (5.5%) and traumatic cases (8.6%; p < 0.001). One-month survival with favorable neurological outcomes was significantly lower in non-cardiac (6.6%) and traumatic cases (0%) than that in cardiac cases (50.2%; p < 0.001). Conclusions: OHCAs of cardiac origin were more frequently associated with VF and had relatively good prognoses. In contrast, OHCAs of non-cardiac and traumatic origins consistently resulted in poor outcomes, highlighting the critical importance of prevention strategies to reduce the occurrence of these incidents. |
| format | Article |
| id | doaj-art-84188694b32748428ee518bfd9f53556 |
| institution | Kabale University |
| issn | 1342-078X 1347-4715 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Environmental Health and Preventive Medicine |
| spelling | doaj-art-84188694b32748428ee518bfd9f535562025-01-30T00:05:38ZengKomiyama Printing Co. LtdEnvironmental Health and Preventive Medicine1342-078X1347-47152025-01-01304410.1265/ehpm.24-00319ehpmCharacteristics and outcomes of out-of-hospital cardiac arrest among students under school supervision in Japan: a descriptive epidemiological study (2008–2021)Kosuke Kiyohara0Mamoru Ayusawa1Masahiko Nitta2Takeichiro Sudo3Taku Iwami4Ken Nakata5Yuri Kitamura6Tetsuhisa Kitamura7https://orcid.org/0000-0003-0107-0580Department of Food Science, Faculty of Home Economics, Otsuma Women’s UniversityDepartment of Nutrition and Health Science, Faculty of Health and Medical Science, Kanagawa Institute of TechnologyDepartment of Emergency Medicine, Osaka Medical and Pharmaceutical UniversityInstitute of Human Culture Studies, Otsuma Women’s UniversityDepartment of Preventive Services, Kyoto University School of Public HealthMedicine for Sports and Performing Arts, Department of Health and Sports Sciences, Graduate School of Medicine, Osaka UniversityDivision of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka UniversityDivision of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka UniversityBackground: A comprehensive understanding of the epidemiology of pediatric out-of-hospital cardiac arrest (OHCA) occurring under school supervision is lacking. We aimed to comprehensively describe the characteristics and outcomes of OHCA among students in elementary schools, junior high schools, high schools, and technical colleges in Japan. Methods: OHCA data from 2008–2021 were obtained from the SPIRITS study, which provides a nationwide database of OHCAs occurring under school supervision across Japan. We included cases in which resuscitation was attempted by emergency medical service personnel or bystanders. The cases were classified into three groups based on their etiology: cardiac, non-cardiac, and traumatic origin. The primary outcome was one-month survival with favorable neurological outcomes, defined as a Glasgow–Pittsburgh cerebral performance category of 1 or 2. The demographic characteristics, event details, and outcomes were compared across the three groups by using χ2 tests for categorical variables and one-way analyses of variance for continuous variables. Results: During the 14-year study period, 602 OHCA cases were confirmed, with 430 (71.4%) classified as cardiac, 91 (15.1%) as non-cardiac, and 81 (13.5%) as traumatic origin. Non-cardiac and traumatic cases were less likely to be witnessed at the time of arrest (46.2% and 42.0%, respectively) than cardiac cases (82.6%; p < 0.001). Initiation of cardiopulmonary resuscitation by bystanders was less common in non-cardiac and traumatic cases (62.6% and 42.0%, respectively) than that in cardiac cases (82.8%; p < 0.001). The delivery of defibrillation using public-access automated external defibrillators was also significantly less frequent in non-cardiac (3.3%) and traumatic cases (6.2%) than that in cardiac cases (59.8%; p < 0.001). Ventricular fibrillation (VF) as the first documented rhythm was observed in 77.9% of cardiac cases but was much less common in non-cardiac (5.5%) and traumatic cases (8.6%; p < 0.001). One-month survival with favorable neurological outcomes was significantly lower in non-cardiac (6.6%) and traumatic cases (0%) than that in cardiac cases (50.2%; p < 0.001). Conclusions: OHCAs of cardiac origin were more frequently associated with VF and had relatively good prognoses. In contrast, OHCAs of non-cardiac and traumatic origins consistently resulted in poor outcomes, highlighting the critical importance of prevention strategies to reduce the occurrence of these incidents.https://www.jstage.jst.go.jp/article/ehpm/30/0/30_24-00319/_html/-char/enout-of-hospital cardiac arrestschoolstudentsjapanetiology of arrestepidemiology |
| spellingShingle | Kosuke Kiyohara Mamoru Ayusawa Masahiko Nitta Takeichiro Sudo Taku Iwami Ken Nakata Yuri Kitamura Tetsuhisa Kitamura Characteristics and outcomes of out-of-hospital cardiac arrest among students under school supervision in Japan: a descriptive epidemiological study (2008–2021) Environmental Health and Preventive Medicine out-of-hospital cardiac arrest school students japan etiology of arrest epidemiology |
| title | Characteristics and outcomes of out-of-hospital cardiac arrest among students under school supervision in Japan: a descriptive epidemiological study (2008–2021) |
| title_full | Characteristics and outcomes of out-of-hospital cardiac arrest among students under school supervision in Japan: a descriptive epidemiological study (2008–2021) |
| title_fullStr | Characteristics and outcomes of out-of-hospital cardiac arrest among students under school supervision in Japan: a descriptive epidemiological study (2008–2021) |
| title_full_unstemmed | Characteristics and outcomes of out-of-hospital cardiac arrest among students under school supervision in Japan: a descriptive epidemiological study (2008–2021) |
| title_short | Characteristics and outcomes of out-of-hospital cardiac arrest among students under school supervision in Japan: a descriptive epidemiological study (2008–2021) |
| title_sort | characteristics and outcomes of out of hospital cardiac arrest among students under school supervision in japan a descriptive epidemiological study 2008 2021 |
| topic | out-of-hospital cardiac arrest school students japan etiology of arrest epidemiology |
| url | https://www.jstage.jst.go.jp/article/ehpm/30/0/30_24-00319/_html/-char/en |
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