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Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: a prospective cohort study
- Source :
- BMC Anesthesiology, Vol 17, Iss 1, Pp 1-8 (2017), BMC Anesthesiology
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- [Background]The duration of cardiopulmonary resuscitation (CPR) is an important factor associated with the outcomes for an out-of-hospital cardiac arrest. However, the appropriate CPR duration remains unclear considering pre- and in-hospital settings. The present study aimed to evaluate the relationship between the CPR duration (including both the pre- and in-hospital duration) and neurologically favorable outcomes 1-month after cardiac arrest. [Methods] Data were utilized from a prospective multi-center cohort study of out-of-hospital cardiac arrest patients transported to 67 emergency hospitals between January 2012 and March 2013 in the Kanto area of Japan. A total of 3, 353 patients with out-of-hospital cardiac arrest (age ≥18 years) who underwent CPR by emergency medical service personnel and achieved the return of spontaneous circulation in a pre- or in-hospital setting were analyzed. The primary outcome was a 1-month favorable neurological outcome. Logistic regression analysis was performed to estimate the influence of cardiopulmonary resuscitation duration. The CPR duration that achieved a cumulative proportion >99% of cases with a 1-month neurologically favorable outcome was determined. [Results] Of the 3, 353 eligible cases, pre-hospital return of spontaneous circulation was obtained in 1, 692 cases (50.5%). A total of 279 (8.3%) cases had a 1-month neurologically favorable outcome. The CPR duration was significantly and inversely associated with 1-month neurologically favorable outcomes with adjustment for pre- and in-hospital confounders (adjusted odds ratio: 0.911, per minute, 95% CI: 0.892–0.929, p 99%. [Conclusions] The CPR duration was independently and inversely associated with 1-month neurologically favorable outcomes after out-of-hospital cardiac arrest. The CPR duration required to achieve return of spontaneous circulation in >99% of out-of-hospital cardiac arrest patients with a 1-month favorable neurological outcome was 45 min, considering both pre- and in-hospital settings.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
030204 cardiovascular system & hematology
Return of spontaneous circulation
Logistic regression
Cohort Studies
lcsh:RD78.3-87.3
Disability Evaluation
03 medical and health sciences
0302 clinical medicine
Japan
Internal medicine
Anesthesiology
medicine
Emergency medical services
Humans
Patient outcome assessment
Cardiopulmonary resuscitation
Prospective cohort study
Aged
Aged, 80 and over
Neurologic Examination
Out-of-hospital cardiac arrest
business.industry
030208 emergency & critical care medicine
Odds ratio
Anesthesiology and Pain Medicine
lcsh:Anesthesiology
Emergency medicine
Cardiology
Female
business
Research Article
Cohort study
Subjects
Details
- ISSN :
- 14712253
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- BMC Anesthesiology
- Accession number :
- edsair.doi.dedup.....45c8b49ff7fd570c6bdc9a57a3a4ad32
- Full Text :
- https://doi.org/10.1186/s12871-017-0351-1