scholarly journals Sex Differences in Receiving Layperson Cardiopulmonary Resuscitation in Pediatric Out‐of‐Hospital Cardiac Arrest: A Nationwide Cohort Study in Japan

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Masashi Okubo ◽  
Tasuku Matsuyama ◽  
Koichiro Gibo ◽  
Sho Komukai ◽  
Junichi Izawa ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Sex Differences ◽  
Cohort Study ◽  
Cardiopulmonary Resuscitation ◽  
Hospital Cardiac Arrest

scholarly journals Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: nationwide cohort study

BMJ ◽  
2019 ◽  
pp. l430 ◽  
Author(s):  
Junichi Izawa ◽  
Sho Komukai ◽  
Koichiro Gibo ◽  
Masashi Okubo ◽  
Kosuke Kiyohara ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cohort Study ◽  
Cardiopulmonary Resuscitation ◽  
Time Dependent ◽  
Adjusted Risk ◽  
Shockable Rhythm ◽  
Adjusted Risk Ratio ◽  
Advanced Airway ◽  
Sequential Matching ◽  
Hospital Cardiac Arrest

Abstract Objective To determine survival associated with advanced airway management (AAM) compared with no AAM for adults with out-of-hospital cardiac arrest. Design Cohort study between January 2014 and December 2016. Setting Nationwide, population based registry in Japan (All-Japan Utstein Registry). Participants Consecutive adult patients with out-of-hospital cardiac arrest, separated into two sub-cohorts by their first documented electrocardiographic rhythm: shockable (ventricular fibrillation or pulseless ventricular tachycardia) and non-shockable (pulseless electrical activity or asystole). Patients who received AAM during cardiopulmonary resuscitation were sequentially matched with patients at risk of AAM within the same minute on the basis of time dependent propensity scores. Main outcome measures Survival at one month or at hospital discharge within one month. Results Of the 310 620 patients eligible, 8459 (41.2%) of 20 516 in the shockable cohort and 121 890 (42.0%) of 290 104 in the non-shockable cohort received AAM during cardiopulmonary resuscitation. After time dependent propensity score sequential matching, 16 114 patients in the shockable cohort and 236 042 in the non-shockable cohort were matched at the same minute. In the shockable cohort, survival did not differ between patients with AAM and those with no AAM: 1546/8057 (19.2%) versus 1500/8057 (18.6%) (adjusted risk ratio 1.00, 95% confidence interval 0.93 to 1.07). In the non-shockable cohort, patients with AAM had better survival than those with no AAM: 2696/118 021 (2.3%) versus 2127/118 021 (1.8%) (adjusted risk ratio 1.27, 1.20 to 1.35). Conclusions In the time dependent propensity score sequential matching for out-of-hospital cardiac arrest in adults, AAM was not associated with survival among patients with shockable rhythm, whereas AAM was associated with better survival among patients with non-shockable rhythm.

scholarly journals Protocol for a cohort study of the impact of the COVID-19 pandemic on the rate and incidence of bystander cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Ingvild B. M. Tjelmeland ◽  
Jan Wnent ◽  
Siobhan Masterson ◽  
Jo Kramer-Johansen ◽  
Jan-Thorsten Gräsner
Keyword(s):  
Cardiac Arrest ◽  
Cohort Study ◽  
Cardiopulmonary Resuscitation ◽  
Early Recognition ◽  
Aggregated Data ◽  
General Data Protection Regulation ◽  
Number Of Patients ◽  
Bystander Cpr ◽  
The Impact ◽  
Hospital Cardiac Arrest

Abstract Background Survival after out-of-hospital cardiac arrest (OHCA) is dependent on early recognition, early cardiopulmonary resuscitation (CPR) and early defibrillation. The purpose of CPR is to maintain some blood flow until the arrival of the emergency medical services (EMS). Our concern is that the COVID-19 pandemic has had a negative effect on the number of patients who get CPR before EMS arrival. The aim of this study is to compare the incidence of bystander CPR during the pandemic with data from before the pandemic. Methods The protocol is for a retrospective cohort study where data from existing registries will be used. All participating registries will share aggregated data from 2017 to 2020, and the study team will compare the results from 2020 to results from 2017 to 2019. Due to the General Data Protection Regulation, each participating registry will check for completeness and plausibility, and perform all aggregation of data locally. In the following analysis different registries will be considered as random samples and analysed by means of a generalized linear mixed effects model with Poisson distribution for the outcome, the population covered as offsets, and different registries as random factors. Discussion This study does not present the prospect of direct benefit to the patient, but does provide an opportunity to gain a better understanding of the epidemiology of bystander CPR for OHCA patients during a pandemic. By comparing data during the pandemic with already collected information in established registries we believe we can gain valuable information about changes in public response to out-of-hospital cardiac arrest.

scholarly journals Cohort study of the characteristics and outcomes in patients with COVID-19 and in-hospital cardiac arrest

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e054943
Author(s):  
Astrid Holm ◽  
Matilda Jerkeman ◽  
Pedram Sultanian ◽  
Peter Lundgren ◽  
Annica Ravn-Fischer ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cohort Study ◽  
Cardiopulmonary Resuscitation ◽  
Observational Study ◽  
Clinical Sign ◽  
Clinical Conditions ◽  
Second Wave ◽  
Hospital Cardiac Arrest ◽  
Pandemic Wave ◽  
Ongoing Infection

ObjectiveWe studied characteristics, survival, causes of cardiac arrest, conditions preceding cardiac arrest, predictors of survival and trends in the prevalence of COVID-19 among in-hospital cardiac arrest (IHCA) cases.Design and settingRegistry-based observational study.ParticipantsWe studied all cases (≥18 years of age) of IHCA receiving cardiopulmonary resuscitation in the Swedish Registry for Cardiopulmonary Resuscitation during 15 March 2020 to 31 December 2020. A total of 1613 patients were included and divided into the following groups: ongoing infection (COVID-19+; n=182), no infection (COVID-19–; n=1062) and unknown/not assessed (n=369).Main outcomes and measuresWe studied monthly trends in proportions of COVID-19 associated IHCAs, causes of IHCA in relation to COVID-19 status, clinical conditions preceding the cardiac arrest and predictors of survival.ResultsThe rate of COVID-19+ patients suffering an IHCA increased to 23% during the first pandemic wave (April), then abated to 3% in July, and then increased to 19% during the second wave (December). Among COVID-19+ cases, 43% had respiratory insufficiency or infection as the underlying cause of the cardiac arrest, compared with 18% among COVID-19– cases. The most common clinical sign preceding cardiac arrest was hypoxia (57%) among COVID-19+ cases. OR for 30-day survival for COVID-19+ cases was 0.50 (95% CI 0.33 to 0.76), compared with COVID-19– cases.ConclusionDuring pandemic peaks, up to one-fourth of all IHCAs are complicated by COVID-19, and these patients have halved chance of survival, with women displaying the worst outcomes.

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