Blank Cover Image

Neurological outcomes in children dead on hospital arrival

フォーマット:
論文
責任表示:
Goto, Yoshikazu ; Funada, Akira ; Nakatsu-Goto, Yumiko
言語:
英語
出版情報:
BioMed Central Ltd., 2015-11-18
著者名:
掲載情報:
Critical Care
ISSN:
1364-8535  CiNii Research  Webcat Plus  JAIRO
巻:
19
通号:
1
開始ページ:
410
バージョン:
publisher
概要:
Introduction: Obtaining favorable neurological outcomes is extremely difficult in children transported to a hospital without a prehospital return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA). However, the crucial prehospital factors affecting outcomes in this cohort remain unclear. We aimed to determine the prehospital factors for survival with favorable neurological outcomes (Cerebral Performance Category 1 or 2 (CPC 1-2)) in children without a prehospital ROSC after OHCA. Methods: Of 9093 OHCA children, 7332 children (age <18years) without a prehospital ROSC after attempting resuscitation were eligible for enrollment. Data were obtained from a prospectively recorded Japanese national Utstein-style database from 2008 to 2012. The primary endpoint was 1-month CPC 1-2 after OHCA. Results: The 1-month survival and 1-month CPC 1-2 rates were 6.92% (n=508) and 0.99% (n=73), respectively. The proportions of the following prehospital variables were significantly higher in the 1-month CPC 1-2 cohort than in the 1-month CPC 3-5 cohort: age (median, 3years (interquartile range (IQR), 0-14) versus 1year (IQR, 0-11), p<0.05), bystander-witnessed arrest (52/73 (71.2%) versus 1830/7259 (25.2%), p<0.001), initial ventricular fibrillation (VF)/pulseless ventricular tachycardia (VT) rhythm (28/73 (38.3%) versus 241/7259 (3.3%), p<0.001), presumed cardiac causes (42/73 (57.5%) versus 2385/7259 (32.8%), p<0.001), and actual shock delivery (25/73 (34.2%) versus 314/7259 (4.3%), p<0.0001). Multivariate logistic regression analysis indicated that 2 prehospital factors were associated with 1-month CPC 1-2: initial non-asystole rhythm (VF/pulseless VT: adjusted odds ratio ( aOR), 16.0; 95% confidence interval (CI), 8.05-32.0; pulseless electrical activity (PEA): aOR, 5.19; 95% CI, 2.77-9.82) and bystander-witnessed arrest (aOR, 3.22; 95% CI, 1.84-5.79). The rate of 1-month CPC 1-2 in witnessed-arrest children with an initial VF/pulseless VT was significantly higher than that in those with other initial cardiac rhythms (15.6% versus 2.3% for PEA and 1.2% for asystole, p for trend<0.001). Conclusions: The crucial prehospital factors for 1-month survival with favorable neurological outcomes after OHCA were initial non-asystole rhythm and bystander-witnessed arrest in children transported to hospitals without a prehospital ROSC. © 2015 Goto et al. 続きを見る
URL:
http://hdl.handle.net/2297/43899
タイトル・著者・出版者が同じ資料

類似資料:

1
 
2
 
3
 
4
 
5
 
6
 
7
 
8
 
9
 
10
 
11
 
12
 

Goto, Yoshikazu, Maeda, Tetsuo, Goto, Yumiko

American Heart Association: JAHA / John Wiley and Sons Inc.

Aratani, Yumiko

U.S. Department of Housing and Urban Development, Office of Policy Development and Research

舟田, 晃, Funada, Akira

金沢大学附属病院救急部

Funada, Akira, Goto, Yoshikazu, Maeda, Tetsuo, Teramoto, Ryota, Hayashi, Kenshi, Yamagishi, Masakazu

日本循環器学会 = The Japanese Circulation Society

Enami, Miki, Takei, Yutaka, Goto, Yoshikazu, Ohta, Keisuke, Inaba, Hideo

Elsevier

Funada, Akira, Goto, Yoshikazu, Tada, Hayato, Teramoto, Ryota, Shimojima, Masaya, Hayashi, Kenshi, Yamagishi, Masakazu, &hellip;

Japanese Circulation Society = 日本循環器学会

後藤, 由和, Goto, Yoshikazu

Nishi, Taiki, Kamikura, Takahisa, Funada, Akira, Myojo, Yasuhiro, Ishida, Tetsuya, Inaba, Hideo

Elsevier

後藤, 由和, Goto, Yoshikazu

金沢大学医薬保健研究域医学系

Takei, Yutaka, Inaba, Hideo, Yachida, Takahiro, Enami, Miki, Goto, Yoshikazu, Ohta, Keisuke

Elsevier

Paine, Richmond Shepard, 1920-1969, Oppe, Thomas Ernest

Spastics Society (Medical Education and Information Unit) in association with Heinemann Medical