Cargando…

Association between the COVID-19 pandemic in 2020 and out-of-hospital cardiac arrest outcomes and bystander resuscitation efforts for working-age individuals in Japan: a nationwide observational and epidemiological analysis

BACKGROUND: Improving out-of-hospital cardiac arrest (OHCA) prognosis within the working-age population is important, but no studies have investigated the effects of COVID-19 pandemic specifically on the working-age population with OHCAs. We aimed to determine the association between the 2020 COVID-...

Descripción completa

Detalles Bibliográficos
Autores principales: Ushimoto, Tomoyuki, Yao, Shintaro, Nunokawa, Chika, Murasaka, Kenshi, Inaba, Hideo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423471/
https://www.ncbi.nlm.nih.gov/pubmed/37280044
http://dx.doi.org/10.1136/emermed-2022-213001
_version_ 1785089459371376640
author Ushimoto, Tomoyuki
Yao, Shintaro
Nunokawa, Chika
Murasaka, Kenshi
Inaba, Hideo
author_facet Ushimoto, Tomoyuki
Yao, Shintaro
Nunokawa, Chika
Murasaka, Kenshi
Inaba, Hideo
author_sort Ushimoto, Tomoyuki
collection PubMed
description BACKGROUND: Improving out-of-hospital cardiac arrest (OHCA) prognosis within the working-age population is important, but no studies have investigated the effects of COVID-19 pandemic specifically on the working-age population with OHCAs. We aimed to determine the association between the 2020 COVID-19 pandemic and OHCA outcomes and bystander resuscitation efforts among the working-age population. METHODS: Prospectively collected nationwide, population-based records concerning 166 538 working-age individuals (men, 20–68 years; women, 20–62 years) with OHCA between 2017 and 2020 were assessed. We compared characteristics and outcome differences of the arrests between three prepandemic years (2017–2019) and the pandemic year 2020. The primary outcome was neurologically favourable 1-month survival (cerebral performance category 1 or 2). Secondary outcomes were bystander cardiopulmonary resuscitation (BCPR), dispatcher-assisted instruction for cardiopulmonary resuscitation (DAI-CPR), bystander-provided defibrillation (public access defibrillation (PAD)) and 1-month survival. We examined variations in bystander resuscitation efforts and outcomes among pandemic phase and regional classifications. RESULTS: Among 149 300 OHCA cases, 1-month survival (2020, 11.2%; 2017–2019, 11.1% (crude OR (cOR) 1.00, 95% CI 0.97 to 1.05)) and 1-month neurologically favourable survival (7.3%–7.3% (cOR 1.00, 95% CI 0.96 to 1.05)) were unchanged; however, the neurologically favourable 1-month survival rate decreased in 12 of the most COVID-19-affected prefectures (7.2%–7.8% (cOR 0.90, 95% CI 0.85 to 0.96)), whereas it increased in 35 other prefectures (7.5%–6.6% (cOR 1.15, 95% CI 1.07 to 1.23)). Favourable outcomes decreased for OHCAs of presumed cardiac aetiology (10.3%–10.9% (cOR 0.94, 95% CI 0.90 to 0.99)) but increased for OHCAs of non-cardiac aetiology (2.5%–2.0% (cOR 1.27, 95% CI 1.12 to 1.44)). BCPR provision increased from 50.7% of arrests prepandemic to 52.3% (crude OR 1.07, 95% CI 1.04 to 1.09). Compared with 2017–2019, home-based OHCAs in 2020 increased (64.8% vs 62.3% (crude OR 1.12, 95% CI 1.09 to 1.14)), along with DAI-CPR attempts (59.5% vs 56.6% (cOR 1.13, 95% CI 1.10 to 1.15)) and multiple calls to determine a destination hospital (16.4% vs 14.5% (cOR 1.16, 95% CI 1.12 to 1.20)). PAD use decreased from 4.0% to 3.7% but only during the state of emergency period (7 April–24 May 2020) and in prefectures significantly affected by COVID-19. CONCLUSIONS: Reviewing automated external defibrillator (AED) locations and increasing BCPR through DAI-CPR may help prevent pandemic-associated decreases in survival rates for patients with cardiac OHCAs.
format Online
Article
Text
id pubmed-10423471
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-104234712023-08-14 Association between the COVID-19 pandemic in 2020 and out-of-hospital cardiac arrest outcomes and bystander resuscitation efforts for working-age individuals in Japan: a nationwide observational and epidemiological analysis Ushimoto, Tomoyuki Yao, Shintaro Nunokawa, Chika Murasaka, Kenshi Inaba, Hideo Emerg Med J Original Research BACKGROUND: Improving out-of-hospital cardiac arrest (OHCA) prognosis within the working-age population is important, but no studies have investigated the effects of COVID-19 pandemic specifically on the working-age population with OHCAs. We aimed to determine the association between the 2020 COVID-19 pandemic and OHCA outcomes and bystander resuscitation efforts among the working-age population. METHODS: Prospectively collected nationwide, population-based records concerning 166 538 working-age individuals (men, 20–68 years; women, 20–62 years) with OHCA between 2017 and 2020 were assessed. We compared characteristics and outcome differences of the arrests between three prepandemic years (2017–2019) and the pandemic year 2020. The primary outcome was neurologically favourable 1-month survival (cerebral performance category 1 or 2). Secondary outcomes were bystander cardiopulmonary resuscitation (BCPR), dispatcher-assisted instruction for cardiopulmonary resuscitation (DAI-CPR), bystander-provided defibrillation (public access defibrillation (PAD)) and 1-month survival. We examined variations in bystander resuscitation efforts and outcomes among pandemic phase and regional classifications. RESULTS: Among 149 300 OHCA cases, 1-month survival (2020, 11.2%; 2017–2019, 11.1% (crude OR (cOR) 1.00, 95% CI 0.97 to 1.05)) and 1-month neurologically favourable survival (7.3%–7.3% (cOR 1.00, 95% CI 0.96 to 1.05)) were unchanged; however, the neurologically favourable 1-month survival rate decreased in 12 of the most COVID-19-affected prefectures (7.2%–7.8% (cOR 0.90, 95% CI 0.85 to 0.96)), whereas it increased in 35 other prefectures (7.5%–6.6% (cOR 1.15, 95% CI 1.07 to 1.23)). Favourable outcomes decreased for OHCAs of presumed cardiac aetiology (10.3%–10.9% (cOR 0.94, 95% CI 0.90 to 0.99)) but increased for OHCAs of non-cardiac aetiology (2.5%–2.0% (cOR 1.27, 95% CI 1.12 to 1.44)). BCPR provision increased from 50.7% of arrests prepandemic to 52.3% (crude OR 1.07, 95% CI 1.04 to 1.09). Compared with 2017–2019, home-based OHCAs in 2020 increased (64.8% vs 62.3% (crude OR 1.12, 95% CI 1.09 to 1.14)), along with DAI-CPR attempts (59.5% vs 56.6% (cOR 1.13, 95% CI 1.10 to 1.15)) and multiple calls to determine a destination hospital (16.4% vs 14.5% (cOR 1.16, 95% CI 1.12 to 1.20)). PAD use decreased from 4.0% to 3.7% but only during the state of emergency period (7 April–24 May 2020) and in prefectures significantly affected by COVID-19. CONCLUSIONS: Reviewing automated external defibrillator (AED) locations and increasing BCPR through DAI-CPR may help prevent pandemic-associated decreases in survival rates for patients with cardiac OHCAs. BMJ Publishing Group 2023-08 2023-06-06 /pmc/articles/PMC10423471/ /pubmed/37280044 http://dx.doi.org/10.1136/emermed-2022-213001 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Ushimoto, Tomoyuki
Yao, Shintaro
Nunokawa, Chika
Murasaka, Kenshi
Inaba, Hideo
Association between the COVID-19 pandemic in 2020 and out-of-hospital cardiac arrest outcomes and bystander resuscitation efforts for working-age individuals in Japan: a nationwide observational and epidemiological analysis
title Association between the COVID-19 pandemic in 2020 and out-of-hospital cardiac arrest outcomes and bystander resuscitation efforts for working-age individuals in Japan: a nationwide observational and epidemiological analysis
title_full Association between the COVID-19 pandemic in 2020 and out-of-hospital cardiac arrest outcomes and bystander resuscitation efforts for working-age individuals in Japan: a nationwide observational and epidemiological analysis
title_fullStr Association between the COVID-19 pandemic in 2020 and out-of-hospital cardiac arrest outcomes and bystander resuscitation efforts for working-age individuals in Japan: a nationwide observational and epidemiological analysis
title_full_unstemmed Association between the COVID-19 pandemic in 2020 and out-of-hospital cardiac arrest outcomes and bystander resuscitation efforts for working-age individuals in Japan: a nationwide observational and epidemiological analysis
title_short Association between the COVID-19 pandemic in 2020 and out-of-hospital cardiac arrest outcomes and bystander resuscitation efforts for working-age individuals in Japan: a nationwide observational and epidemiological analysis
title_sort association between the covid-19 pandemic in 2020 and out-of-hospital cardiac arrest outcomes and bystander resuscitation efforts for working-age individuals in japan: a nationwide observational and epidemiological analysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423471/
https://www.ncbi.nlm.nih.gov/pubmed/37280044
http://dx.doi.org/10.1136/emermed-2022-213001
work_keys_str_mv AT ushimototomoyuki associationbetweenthecovid19pandemicin2020andoutofhospitalcardiacarrestoutcomesandbystanderresuscitationeffortsforworkingageindividualsinjapananationwideobservationalandepidemiologicalanalysis
AT yaoshintaro associationbetweenthecovid19pandemicin2020andoutofhospitalcardiacarrestoutcomesandbystanderresuscitationeffortsforworkingageindividualsinjapananationwideobservationalandepidemiologicalanalysis
AT nunokawachika associationbetweenthecovid19pandemicin2020andoutofhospitalcardiacarrestoutcomesandbystanderresuscitationeffortsforworkingageindividualsinjapananationwideobservationalandepidemiologicalanalysis
AT murasakakenshi associationbetweenthecovid19pandemicin2020andoutofhospitalcardiacarrestoutcomesandbystanderresuscitationeffortsforworkingageindividualsinjapananationwideobservationalandepidemiologicalanalysis
AT inabahideo associationbetweenthecovid19pandemicin2020andoutofhospitalcardiacarrestoutcomesandbystanderresuscitationeffortsforworkingageindividualsinjapananationwideobservationalandepidemiologicalanalysis