Characteristics and outcomes of out‐of‐hospital cardiac arrest in a hilly area: Utstein Registry data from the Nagasaki Medical Region, Japan

Abstract Aim To analyze characteristics and investigate prognostic indicators of out‐of‐hospital cardiac arrest (OHCA) in a hilly area in Japan. Methods A retrospective population‐based study was conducted using the Utstein Registry for 4280 OHCA patients in the Nagasaki Medical Region (NMR) registe...

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Main Authors: Valeryia Zmushka, Goro Tajima, Keita Iyama, Koichi Hayakawa, Kazunori Yamashita, Takamitsu Inokuma, Hiroo Izumino, Takanobu Otaguro, Eri Uemura, Tomohiro Ueki, Shimon Murahashi, Shuhei Yamano, Kensuke Takahashi, Yoshihiro Aoki, Atsuko Tachikawa, Osamu Tasaki
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Acute Medicine & Surgery
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Online Access:https://doi.org/10.1002/ams2.966
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author Valeryia Zmushka
Goro Tajima
Keita Iyama
Koichi Hayakawa
Kazunori Yamashita
Takamitsu Inokuma
Hiroo Izumino
Takanobu Otaguro
Eri Uemura
Tomohiro Ueki
Shimon Murahashi
Shuhei Yamano
Kensuke Takahashi
Yoshihiro Aoki
Atsuko Tachikawa
Osamu Tasaki
author_facet Valeryia Zmushka
Goro Tajima
Keita Iyama
Koichi Hayakawa
Kazunori Yamashita
Takamitsu Inokuma
Hiroo Izumino
Takanobu Otaguro
Eri Uemura
Tomohiro Ueki
Shimon Murahashi
Shuhei Yamano
Kensuke Takahashi
Yoshihiro Aoki
Atsuko Tachikawa
Osamu Tasaki
author_sort Valeryia Zmushka
collection DOAJ
description Abstract Aim To analyze characteristics and investigate prognostic indicators of out‐of‐hospital cardiac arrest (OHCA) in a hilly area in Japan. Methods A retrospective population‐based study was conducted using the Utstein Registry for 4280 OHCA patients in the Nagasaki Medical Region (NMR) registered over the 10‐year period from 2011 to 2020. The main outcome measure was a favorable cerebral performance category (CPC 1–2). Sites at which OHCA occurred were classified into “sloped places (SPs)” (not easily accessible by emergency medical services [EMS] personnel due to slopes) and “accessible places (APs)” (EMS personnel could park an ambulance close to the site). The characteristics and prognosis based on CPC were compared between SPs and APs, and multivariable analysis was performed. Results No significant improvement in prognosis occurred in the NMR from 2011 to 2020. Prognosis in SPs was significantly worse than that in APs. However, multivariable analysis did not identify SP as a prognostic indicator. The following factors were associated with survival and CPC 1–2: age group, witness status, first documented rhythm, bystander‐initiated cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use, use of mechanical CPR (m‐CPR) device or esophageal obturator airway (EOA), and year. Both m‐CPR and EOA use were associated with a poor prognosis. Conclusion In a hilly area, OHCA patients in SPs had a worse prognosis than those in APs, but SPs was not significantly associated with prognosis by multivariable analysis. Interventions to increase bystander‐initiated CPR and AED use could potentially improve outcomes of OHCA in the NMR.
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spelling doaj-art-b652b5f37a6748fcb47b3beceddfa5e02025-08-20T02:52:52ZengWileyAcute Medicine & Surgery2052-88172024-01-01111n/an/a10.1002/ams2.966Characteristics and outcomes of out‐of‐hospital cardiac arrest in a hilly area: Utstein Registry data from the Nagasaki Medical Region, JapanValeryia Zmushka0Goro Tajima1Keita Iyama2Koichi Hayakawa3Kazunori Yamashita4Takamitsu Inokuma5Hiroo Izumino6Takanobu Otaguro7Eri Uemura8Tomohiro Ueki9Shimon Murahashi10Shuhei Yamano11Kensuke Takahashi12Yoshihiro Aoki13Atsuko Tachikawa14Osamu Tasaki15Disaster and Radiation Medical Sciences, Medical Sciences Course, Graduate School of Biomedical Sciences Nagasaki University Nagasaki JapanNagasaki University Hospital Acute & Critical Care Center Nagasaki JapanNagasaki University Hospital Acute & Critical Care Center Nagasaki JapanNagasaki University Hospital Acute & Critical Care Center Nagasaki JapanNagasaki University Hospital Acute & Critical Care Center Nagasaki JapanNagasaki University Hospital Acute & Critical Care Center Nagasaki JapanNagasaki University Hospital Acute & Critical Care Center Nagasaki JapanNagasaki University Hospital Acute & Critical Care Center Nagasaki JapanNagasaki University Hospital Acute & Critical Care Center Nagasaki JapanNagasaki University Hospital Acute & Critical Care Center Nagasaki JapanNagasaki University Hospital Acute & Critical Care Center Nagasaki JapanNagasaki University Hospital Acute & Critical Care Center Nagasaki JapanNagasaki University Hospital Acute & Critical Care Center Nagasaki JapanNagasaki University Hospital Acute & Critical Care Center Nagasaki JapanNagasaki University Hospital Acute & Critical Care Center Nagasaki JapanDisaster and Radiation Medical Sciences, Medical Sciences Course, Graduate School of Biomedical Sciences Nagasaki University Nagasaki JapanAbstract Aim To analyze characteristics and investigate prognostic indicators of out‐of‐hospital cardiac arrest (OHCA) in a hilly area in Japan. Methods A retrospective population‐based study was conducted using the Utstein Registry for 4280 OHCA patients in the Nagasaki Medical Region (NMR) registered over the 10‐year period from 2011 to 2020. The main outcome measure was a favorable cerebral performance category (CPC 1–2). Sites at which OHCA occurred were classified into “sloped places (SPs)” (not easily accessible by emergency medical services [EMS] personnel due to slopes) and “accessible places (APs)” (EMS personnel could park an ambulance close to the site). The characteristics and prognosis based on CPC were compared between SPs and APs, and multivariable analysis was performed. Results No significant improvement in prognosis occurred in the NMR from 2011 to 2020. Prognosis in SPs was significantly worse than that in APs. However, multivariable analysis did not identify SP as a prognostic indicator. The following factors were associated with survival and CPC 1–2: age group, witness status, first documented rhythm, bystander‐initiated cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use, use of mechanical CPR (m‐CPR) device or esophageal obturator airway (EOA), and year. Both m‐CPR and EOA use were associated with a poor prognosis. Conclusion In a hilly area, OHCA patients in SPs had a worse prognosis than those in APs, but SPs was not significantly associated with prognosis by multivariable analysis. Interventions to increase bystander‐initiated CPR and AED use could potentially improve outcomes of OHCA in the NMR.https://doi.org/10.1002/ams2.966cardiopulmonary resuscitationemergency medical systemhilly areamechanical resuscitationout‐of‐hospital cardiac arrest
spellingShingle Valeryia Zmushka
Goro Tajima
Keita Iyama
Koichi Hayakawa
Kazunori Yamashita
Takamitsu Inokuma
Hiroo Izumino
Takanobu Otaguro
Eri Uemura
Tomohiro Ueki
Shimon Murahashi
Shuhei Yamano
Kensuke Takahashi
Yoshihiro Aoki
Atsuko Tachikawa
Osamu Tasaki
Characteristics and outcomes of out‐of‐hospital cardiac arrest in a hilly area: Utstein Registry data from the Nagasaki Medical Region, Japan
Acute Medicine & Surgery
cardiopulmonary resuscitation
emergency medical system
hilly area
mechanical resuscitation
out‐of‐hospital cardiac arrest
title Characteristics and outcomes of out‐of‐hospital cardiac arrest in a hilly area: Utstein Registry data from the Nagasaki Medical Region, Japan
title_full Characteristics and outcomes of out‐of‐hospital cardiac arrest in a hilly area: Utstein Registry data from the Nagasaki Medical Region, Japan
title_fullStr Characteristics and outcomes of out‐of‐hospital cardiac arrest in a hilly area: Utstein Registry data from the Nagasaki Medical Region, Japan
title_full_unstemmed Characteristics and outcomes of out‐of‐hospital cardiac arrest in a hilly area: Utstein Registry data from the Nagasaki Medical Region, Japan
title_short Characteristics and outcomes of out‐of‐hospital cardiac arrest in a hilly area: Utstein Registry data from the Nagasaki Medical Region, Japan
title_sort characteristics and outcomes of out of hospital cardiac arrest in a hilly area utstein registry data from the nagasaki medical region japan
topic cardiopulmonary resuscitation
emergency medical system
hilly area
mechanical resuscitation
out‐of‐hospital cardiac arrest
url https://doi.org/10.1002/ams2.966
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