Open AccessInvestigation and treatment of pulmonary embolism as a potential etiology may be important to improve post‐resuscitation prognosis in non‐shockable out‐of‐hospital cardiopulmonary arrest: report on an analysis of the SOS‐KANTO 2012 study
Author(s) -
Sadaki Inokuchi,
Yoshihiro Masui,
Katsuya Miura,
Haruhiko Tsutsumi,
Kiyotsugu Takuma,
Ishihara Atsushi,
Masataka Nakano,
Hiroyuki Tanaka,
Keiichi Ikegami,
Takao Arai,
Arino Yaguchi,
Nobuya Kitamura,
Shinya Oda,
Kenji Kobayashi,
Takayuki Suda,
Kota Ono,
Naoto Morimura,
Ryosuke Furuya,
Yuuichi Koido,
Fumiaki Iwase,
Ken Nagao,
Shigeru Kanesaka,
Yohei Okada,
Kyoko Unemoto,
Tomohito Sadahiro,
Masayuki Iyanaga,
Asaki Muraoka,
Masanori Hayashi,
Shinichi Ishimatsu,
Yoshihiro Miyake,
Hideo Yokokawa,
Yoshinori Koyama,
Asuka Tsuchiya,
Tetsuya Kashiyama,
Kiyohiro Oshima,
Kazuya Kiyota,
Yuichi Hamabe,
Hiroyuki Yokota,
Shingo Hori,
Susumu Inaba,
Tetsuya Sakamoto,
Naoshige Harada,
Akio Kimura,
Masayuki Kanai,
Yasuhiro Otomo,
Manabu Sugita,
Kosaku Kinoshita,
Takatoshi Sakurai,
Mitsuhide Kitano,
Kiyoshi Matsuda,
Kenzö Tanaka,
Kazuhiro Yoshihara,
Kikuo Yoh,
Junichi Suzuki,
Hiroshi Toyoda,
Kunihiro Mashiko,
Naoki Shimizu,
Takashi Muguruma,
Tadanaga Shimada,
Yoshiro Kobe,
Tomohisa Shoko,
Koji Nakanishi,
Takashi Shiga,
Takefumi Yamamoto,
Keitaro Sekine,
Shinichi Izuka
Publication year - 2016
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.183
Subject(s) - medicine , cardiopulmonary resuscitation , etiology , pulmonary embolism , intensive care medicine , emergency medicine , resuscitation , medical emergency , anesthesia , cardiology
Background The prognosis of non‐shockable out‐of‐hospital cardiac arrest is worse than that of shockable out‐of‐hospital cardiac arrest. We investigated the associations between the etiology and prognosis of non‐shockable out‐of‐hospital cardiac arrest patients who experienced the return of spontaneous circulation after arriving at hospital. Methods and Results All subjects were extracted from the SOS‐KANTO 2012 study population. The subjects were 3,031 adults: (i) who had suffered out‐of‐hospital cardiac arrest, (ii) for whom there were no pre‐hospital data on ventricular fibrillation/pulseless ventricular tachycardia until arrival at hospital, (iii) who experienced the return of spontaneous circulation after arriving at hospital. We compared the patients' prognosis after 1 and 3 months between various etiological and presumed cardiac factors. The proportion of the favorable brain function patients that developed pulmonary embolism or incidental hypothermia was significantly higher than that of the patients with presumed cardiac factors (1 month, P < 0.0001 and P < 0.0001, respectively; 3 months, P = 0.0018 and P < 0.0001, respectively). In multiple logistic regression analysis, pulmonary embolism and incidental hypothermia were found to be significant independent prognostic factors for 1‐ and 3‐month survival and the favorable brain function rate. Conclusions In patients who suffer non‐shockable out‐of‐hospital cardiac arrest, but who experience the return of spontaneous circulation after arriving at hospital, the investigation and treatment of pulmonary embolism as a potential etiology may be important for improving post‐resuscitation prognosis.