論文

査読有り 国際誌
2017年12月1日

Prehospital intravenous access for survival from out-of-hospital cardiac arrest: propensity score matched analyses from a population-based cohort study in Osaka, Japan.

BMJ open
  • Tomoko Fujii
  • ,
  • Tetsuhisa Kitamura
  • ,
  • Kentaro Kajino
  • ,
  • Kosuke Kiyohara
  • ,
  • Chika Nishiyama
  • ,
  • Tatsuya Nishiuchi
  • ,
  • Yasuyuki Hayashi
  • ,
  • Takashi Kawamura
  • ,
  • Taku Iwami

7
12
開始ページ
e015055
終了ページ
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1136/bmjopen-2016-015055

OBJECTIVES: Prehospital intravenous access is a common intervention for patients with out-of-hospital cardiac arrest (OHCA). We aimed to assess the effectiveness of prehospital intravenous access and subsequent epinephrine administration on outcomes among OHCA patients. METHODS: We conducted a prospective cohort study of patients with OHCA from non-traumatic causes aged ≥18 years in Osaka, Japan from January 2005 through December 2012. The primary outcome was 1-month survival with favourable neurological outcome defined as a cerebral performance category of 1 or 2. The association between intravenous line placement and survival with favourable neurological outcome was evaluated by logistic regression, after propensity score matching for the intravenous access attempt stratified by initial documented rhythm of ventricular fibrillation (VF) or non-VF. The contribution of epinephrine administration to the outcome was also explored. RESULTS: Among OHCA patients during the study period, 3208 VF patients and 38 175 non-VF patients were included in our analysis. Intravenous access attempt was negatively associated with 1-month survival with a favourable neurological outcome in VF group (OR 0.76, 95% CI 0.59 to 0.98), while no association was observed in the non-VF group (OR 1.06, 95% CI 0.84 to 1.34). Epinephrine administration had no positive association in the VF patients (OR 0.75, 95% CI 0.51 to 1.07) and positively associated in the non-VF patients (OR 1.52, 95% CI 1.08 to 2.08) with the favourable neurological outcome. CONCLUSIONS: Intravenous access attempt could be negatively associated with survival with a favourable neurological outcome after OHCA. Subsequent epinephrine administration might be effective for non-VF OHCAs.

リンク情報
DOI
https://doi.org/10.1136/bmjopen-2016-015055
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/29197833
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719330
Scopus Url
http://www.scopus.com/inward/record.url?eid=2-s2.0-85037734201&partnerID=MN8TOARS
ID情報
  • DOI : 10.1136/bmjopen-2016-015055
  • ORCIDのPut Code : 61182819
  • PubMed ID : 29197833
  • PubMed Central 記事ID : PMC5719330
  • SCOPUS ID : 85037734201

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