Benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest: a community-based, observational study in Niigata, Japan
Objective This study aimed to assess the benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest using a community-based registry.Design Population-based, retrospective cohort study.Setting An urban city with approximately 800 000 residents.Participants...
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BMJ Publishing Group
2019-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/11/e032967.full |
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| author | Tasuku Matsuyama Nobuhiro Sato Kohei Akazawa Kyoko Nakazawa Yasuo Hirose |
| author_facet | Tasuku Matsuyama Nobuhiro Sato Kohei Akazawa Kyoko Nakazawa Yasuo Hirose |
| author_sort | Tasuku Matsuyama |
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| description | Objective This study aimed to assess the benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest using a community-based registry.Design Population-based, retrospective cohort study.Setting An urban city with approximately 800 000 residents.Participants Patients aged ≥18 years with bystander-witnessed out-of-hospital cardiac arrests of medical aetiology in Niigata City, Japan, between January 2012 and December 2016, according to the Utstein style.Primary and secondary outcome measures The primary outcome was 1-month survival with a favourable neurological outcome, defined as a cerebral performance category score of 1 or 2. We used logistic regression analysis to assess the association between favourable neurological outcome and prehospital physician involvement.Results During the study period, a total of 4172 cardiac arrests were registered; of these, 892 patients with out-of-hospital cardiac arrest were eligible for this analysis, among whom 135 (15.1%) had prehospital physician involvement and 757 (84.9%) did not have prehospital physician involvement. The percentage of favourable neurological outcomes was 20.7% (28 of 135) in those with physician involvement and 10.4% (79 of 757) in those without physician involvement (p=0.001). Using multivariable logistic regression, prehospital physician involvement had an OR for a favourable neurological outcome of 3.44 (95% CI 1.64 to 7.23).Conclusions Among adults with out-of-hospital cardiac arrest, adding a physician-staffed ambulance was associated with significantly greater favourable neurological outcomes than standard emergency medical services. |
| format | Article |
| id | doaj-art-dbaeacfcc7674c0babff60d3ae38bf3c |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-dbaeacfcc7674c0babff60d3ae38bf3c2024-11-27T22:30:17ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2019-032967Benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest: a community-based, observational study in Niigata, JapanTasuku Matsuyama0Nobuhiro Sato1Kohei Akazawa2Kyoko Nakazawa3Yasuo Hirose4Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto, JapanDepartment of Microbiota Research, Juntendo University, Bunkyo-ku, Japan3 Department of Medical Informatics and Statistics, Niigata University Graduate School of Medicine, Niigata, Japan3 Department of Medical Informatics and Statistics, Niigata University Graduate School of Medicine, Niigata, Japan1 Department of Emergency and Critical Care Medicine, Niigata City General Hospital, Niigata, JapanObjective This study aimed to assess the benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest using a community-based registry.Design Population-based, retrospective cohort study.Setting An urban city with approximately 800 000 residents.Participants Patients aged ≥18 years with bystander-witnessed out-of-hospital cardiac arrests of medical aetiology in Niigata City, Japan, between January 2012 and December 2016, according to the Utstein style.Primary and secondary outcome measures The primary outcome was 1-month survival with a favourable neurological outcome, defined as a cerebral performance category score of 1 or 2. We used logistic regression analysis to assess the association between favourable neurological outcome and prehospital physician involvement.Results During the study period, a total of 4172 cardiac arrests were registered; of these, 892 patients with out-of-hospital cardiac arrest were eligible for this analysis, among whom 135 (15.1%) had prehospital physician involvement and 757 (84.9%) did not have prehospital physician involvement. The percentage of favourable neurological outcomes was 20.7% (28 of 135) in those with physician involvement and 10.4% (79 of 757) in those without physician involvement (p=0.001). Using multivariable logistic regression, prehospital physician involvement had an OR for a favourable neurological outcome of 3.44 (95% CI 1.64 to 7.23).Conclusions Among adults with out-of-hospital cardiac arrest, adding a physician-staffed ambulance was associated with significantly greater favourable neurological outcomes than standard emergency medical services.https://bmjopen.bmj.com/content/9/11/e032967.full |
| spellingShingle | Tasuku Matsuyama Nobuhiro Sato Kohei Akazawa Kyoko Nakazawa Yasuo Hirose Benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest: a community-based, observational study in Niigata, Japan BMJ Open |
| title | Benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest: a community-based, observational study in Niigata, Japan |
| title_full | Benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest: a community-based, observational study in Niigata, Japan |
| title_fullStr | Benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest: a community-based, observational study in Niigata, Japan |
| title_full_unstemmed | Benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest: a community-based, observational study in Niigata, Japan |
| title_short | Benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest: a community-based, observational study in Niigata, Japan |
| title_sort | benefits of adding a physician staffed ambulance to bystander witnessed out of hospital cardiac arrest a community based observational study in niigata japan |
| url | https://bmjopen.bmj.com/content/9/11/e032967.full |
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