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Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: a prospective cohort study

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 relation...

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Autores principales: Kashiura, Masahiro, Hamabe, Yuichi, Akashi, Akiko, Sakurai, Atsushi, Tahara, Yoshio, Yonemoto, Naohiro, Nagao, Ken, Yaguchi, Arino, Morimura, Naoto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5401557/
https://www.ncbi.nlm.nih.gov/pubmed/28431508
http://dx.doi.org/10.1186/s12871-017-0351-1
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author Kashiura, Masahiro
Hamabe, Yuichi
Akashi, Akiko
Sakurai, Atsushi
Tahara, Yoshio
Yonemoto, Naohiro
Nagao, Ken
Yaguchi, Arino
Morimura, Naoto
author_facet Kashiura, Masahiro
Hamabe, Yuichi
Akashi, Akiko
Sakurai, Atsushi
Tahara, Yoshio
Yonemoto, Naohiro
Nagao, Ken
Yaguchi, Arino
Morimura, Naoto
author_sort Kashiura, Masahiro
collection PubMed
description 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 < 0.001). After 30 min of CPR, the probability of a 1-month neurologically favorable outcome decreased from 8.3 to 0.7%. At 45 min of CPR, the cumulative proportion for a 1-month neurologically favorable outcome reached >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.
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spelling pubmed-54015572017-04-24 Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: a prospective cohort study Kashiura, Masahiro Hamabe, Yuichi Akashi, Akiko Sakurai, Atsushi Tahara, Yoshio Yonemoto, Naohiro Nagao, Ken Yaguchi, Arino Morimura, Naoto BMC Anesthesiol Research Article 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 < 0.001). After 30 min of CPR, the probability of a 1-month neurologically favorable outcome decreased from 8.3 to 0.7%. At 45 min of CPR, the cumulative proportion for a 1-month neurologically favorable outcome reached >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. BioMed Central 2017-04-21 /pmc/articles/PMC5401557/ /pubmed/28431508 http://dx.doi.org/10.1186/s12871-017-0351-1 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kashiura, Masahiro
Hamabe, Yuichi
Akashi, Akiko
Sakurai, Atsushi
Tahara, Yoshio
Yonemoto, Naohiro
Nagao, Ken
Yaguchi, Arino
Morimura, Naoto
Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: a prospective cohort study
title Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: a prospective cohort study
title_full Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: a prospective cohort study
title_fullStr Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: a prospective cohort study
title_full_unstemmed Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: a prospective cohort study
title_short Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: a prospective cohort study
title_sort association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: a prospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5401557/
https://www.ncbi.nlm.nih.gov/pubmed/28431508
http://dx.doi.org/10.1186/s12871-017-0351-1
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