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Neurocritical Care

, Volume 30, Issue 2, pp 429–439 | Cite as

Association Between Therapeutic Hypothermia and Outcomes in Patients with Non-shockable Out-of-Hospital Cardiac Arrest Developed After Emergency Medical Service Arrival (SOS-KANTO 2012 Analysis Report)

  • Minoru Yoshida
  • Toru Yoshida
  • Yoshihiro Masui
  • Shigeki FujitaniEmail author
  • Yasuhiko Taira
  • Nobuya Kitamura
  • Yoshio Tahara
  • Atsushi Sakurai
  • Naohiro Yonemoto
  • Ken Nagao
  • Arino Yaguchi
  • Naoto Morimura
Original Article
  • 202 Downloads

Abstract

Background/objective

The outcomes of patients with non-shockable out-of-hospital cardiac arrest (non-shockable OHCA) are poorer than those of patients with shockable out-of-hospital cardiac arrest (shockable OHCA). In this retrospective study, we selected patients from the SOS-KANTO 2012 study with non-shockable OHCA that developed after emergency medical service (EMS) arrival and analyzed the effect of therapeutic hypothermia (TH) on non-shockable OHCA patients.

Methods

Of 16,452 patients who have definitive data on the 3-month outcome in the SOS-KANTO 2012 study, we selected 241 patients who met the following criteria: age ≥ 18 years, normal spontaneous respiration or palpable pulse upon emergency medical services arrival, no ventricular fibrillation or pulseless ventricular tachycardia before hospital arrival, and achievement of spontaneous circulation without cardiopulmonary bypass. Patients were divided into two groups based on the presence or absence of TH and were analyzed.

Results

Of the 241 patients, 49 underwent TH. Univariate analysis showed that the 1-/3-month survival rates and favorable 3-month cerebral function outcome rates in the TH group were significantly better than the non-TH group (46% vs 19%, respectively, P < 0.001, 35% vs 12%, respectively, P < 0.001, 20% vs 7%, respectively, P = 0.01). Multivariate logistic regression analysis showed that TH was a significant, independent prognostic factor for cerebral function outcome.

Conclusions

In this study, TH was an independent prognostic factor for the 3-month cerebral function outcome. Even in patients with non-shockable OHCA, TH may improve outcome if the interval from the onset of cardiopulmonary arrest is relatively short, and adequate cardiopulmonary resuscitation is initiated immediately after onset.

Keywords

Out of hospital cardiac arrest Non-shockable OHCA Cardiopulmonay resuscitation Therapeutic hypothermia Survival rate Cerebral outcome Emergency medical service 

Notes

Acknowledgements

We also thank Ms. Mai Matsumoto, and the secretariat of the Japanese Association for Acute Medicine of Kanto, for their help in collecting the data and coordinating our project. We are proud of all the bystanders who undertook basic resuscitation in the cases described in this study, and all of the firefighters, EMS, nurses, physicians, and other healthcare professionals in the Kanto region.

Author Contribution

MY designed the study, collected the data, conducted the statistical analysis, analyzed the data, wrote the initial draft of the paper, and participated in revising the manuscript and addressing the reviewers’ comments. TY designed the study, collected the data, analyzed the data, provided guidance on statistical analysis, assisted with manuscript development, and participated in revising the manuscript and addressing the reviewers’ comments. YM and YT analyzed the data, assisted with manuscript development, and participated in revising the manuscript and addressing the reviewers’ comments. SF designed the study, analyzed the data, provided guidance on statistical analysis, assisted with manuscript development, and participated in revising the manuscript and addressing the reviewers’ comments. NK developed the project (SOS-KANTO 2012 study), analyzed the data, provided guidance on statistical analysis, assisted with manuscript development, and participated in revising the manuscript and addressing the reviewers’ comments. YT and AS developed the project (SOS-KANTO 2012 study), collected data, assisted with manuscript development, and participated in revising the manuscript and addressing the reviewers’ comments. NY developed the project (SOS-KANTO 2012 study), collected data, provided guidance on statistical analysis, assisted with manuscript development, and participated in revising the manuscript and addressing the reviewers’ comments. KN, AY and NM developed the project (SOS-KANTO 2012 study), assisted with manuscript development, and participated in revising the manuscript and addressing the reviewers’ comments.

Source of Support

This study was supported by the Japanese Association for Acute Medicine of Kanto. The funder had no role in the execution of this study or interpretation of the results.

Compliance with Ethical Standards

Conflicts of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2018

Authors and Affiliations

  • Minoru Yoshida
    • 1
  • Toru Yoshida
    • 1
  • Yoshihiro Masui
    • 1
  • Shigeki Fujitani
    • 1
    Email author
  • Yasuhiko Taira
    • 1
  • Nobuya Kitamura
    • 2
  • Yoshio Tahara
    • 3
  • Atsushi Sakurai
    • 4
  • Naohiro Yonemoto
    • 5
  • Ken Nagao
    • 6
  • Arino Yaguchi
    • 7
  • Naoto Morimura
    • 8
  1. 1.Department of Emergency and Critical Care MedicineSt. Marianna University School of MedicineKawasakiJapan
  2. 2.Department of Emergency and Critical Care MedicineKimitsu Chuo HospitalChibaJapan
  3. 3.National Cerebral and Cardiovascular Center HospitalOsakaJapan
  4. 4.Division of Emergency and Critical Care Medicine, Department of Acute MedicineNihon University School of MedicineTokyoJapan
  5. 5.Department of BiostatisticsKyoto University School of Public HealthKyotoJapan
  6. 6.Cardiovascular Center, Nihon University Surugadai HospitalTokyoJapan
  7. 7.Department of Critical Care and Emergency MedicineTokyo Women’s Medical UniversityTokyoJapan
  8. 8.Department of Emergency and Critical Care Medicine, Graduate School of MedicineThe University of TokyoTokyoJapan

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