著者
Kosuke Kiyohara Tomohiko Sakai Chika Nishiyama Tatsuya Nishiuchi Yasuyuki Hayashi Taku Iwami Tetsuhisa Kitamura
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20160179, (Released:2017-10-28)
参考文献数
25
被引用文献数
21

Background: Japanese rice cake (“mochi”) is a major cause of food-choking accidents in Japan. However, the epidemiology of out-of-hospital cardiac arrests (OHCAs) due to suffocation caused by rice cakes is poorly understood.Methods: OHCA data from 2005 to 2012 were obtained from the population-based OHCA registry in Osaka Prefecture. Patients aged ≥20 years who experienced OHCA caused by suffocation that occurred before the arrival of emergency-medical-service (EMS) personnel were included. Patient characteristics, prehospital interventions, and outcomes were compared based on the cause of suffocation (rice cake and non-rice-cake). The primary outcome was 1-month survival after OHCA.Results: In total, 46 911 adult OHCAs were observed during the study period. Of the OHCAs, 7.0% (3,294/46,911) were due to suffocation, with choking due to rice cake as the cause in 9.5% of cases (314/3,294), and of these, 24.5% (77/314) occurred during the first 3 days of the New Year. In crude analysis, 1-month survival was 17.2% (54/314) in those with suffocation caused by rice cake and 13.4% (400/2,980) in those with suffocation due to other causes. In the multivariable analysis for all-cause suffocation, younger age, arrest witnessed by bystanders, and earlier EMS response time were significantly related to better 1-month survival.Conclusion: Approximately 10% of OHCAs due to suffocation were caused by rice-cake choking, and 25% of these occurred during the first 3 days of the New Year. Further efforts for establishing preventive measures as well as improving the early recognition of choking and encouraging bystanders to call EMS sooner are needed.
著者
Yasuyuki Hayashi Taku Iwami Tetsuhisa Kitamura Tatsuya Nishiuchi Kentaro Kajino Tomohiko Sakai Chika Nishiyama Masahiko Nitta Atsushi Hiraide Tatsuro Kai
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.76, no.7, pp.1639-1645, 2012 (Released:2012-06-25)
参考文献数
35
被引用文献数
51 89

Background: The effectiveness of epinephrine administration for cardiac arrests has been shown in animal models, but the clinical effect is still controversial. Methods and Results: A prospective, population-based, observational study in Osaka involved consecutive out-of-hospital cardiac arrest (OHCA) patients from January 2007 through December 2009. We evaluated the outcomes among adult non-traumatic bystander-witnessed OHCA patients for whom the local protocol directed the emergency medical service personnel to administer epinephrine. After stratifying by first documented cardiac rhythm, outcomes were compared among the following groups: non-administration, ≤10, 11-20 and ≥21min as the time from emergency call to epinephrine administration. A total of 3,161 patients were eligible for our analyses, among whom 1,013 (32.0%) actually received epinephrine. The epinephrine group had a significantly lower rate of neurologically intact 1-month survival than the non-epinephrine group (4.1% vs. 6.1%, P=0.028). In cases of ventricular fibrillation (VF) arrest, patients in the early epinephrine group who received epinephrine administration within 10min had a significantly higher rate of neurologically intact 1-month survival compared with the non-epinephrine group (66.7% vs. 24.9%), though other epinephrine groups did not. In cases of non-VF arrest, the rate of neurologically intact 1-month survival was low, irrespective of epinephrine administration. Conclusions: The effectiveness of epinephrine after OHCA depends on the time of administration. When epinephrine is administered in the early phase, there is an improvement in neurological outcome from OHCA with VF.  (Circ J 2012; 76: 1639–1645)
著者
Kosuke Kiyohara Tomohiko Sakai Chika Nishiyama Tatsuya Nishiuchi Yasuyuki Hayashi Taku Iwami Tetsuhisa Kitamura
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.28, no.2, pp.67-74, 2018-02-05 (Released:2018-02-05)
参考文献数
25
被引用文献数
9 21

Background: Japanese rice cake (“mochi”) is a major cause of food-choking accidents in Japan. However, the epidemiology of out-of-hospital cardiac arrests (OHCAs) due to suffocation caused by rice cakes is poorly understood.Methods: OHCA data from 2005 to 2012 were obtained from the population-based OHCA registry in Osaka Prefecture. Patients aged ≥20 years who experienced OHCA caused by suffocation that occurred before the arrival of emergency-medical-service (EMS) personnel were included. Patient characteristics, prehospital interventions, and outcomes were compared based on the cause of suffocation (rice cake and non-rice-cake). The primary outcome was 1-month survival after OHCA.Results: In total, 46 911 adult OHCAs were observed during the study period. Of the OHCAs, 7.0% (3,294/46,911) were due to suffocation, with choking due to rice cake as the cause in 9.5% of cases (314/3,294), and of these, 24.5% (77/314) occurred during the first 3 days of the New Year. In crude analysis, 1-month survival was 17.2% (54/314) in those with suffocation caused by rice cake and 13.4% (400/2,980) in those with suffocation due to other causes. In the multivariable analysis for all-cause suffocation, younger age, arrest witnessed by bystanders, and earlier EMS response time were significantly related to better 1-month survival.Conclusion: Approximately 10% of OHCAs due to suffocation were caused by rice-cake choking, and 25% of these occurred during the first 3 days of the New Year. Further efforts for establishing preventive measures as well as improving the early recognition of choking and encouraging bystanders to call EMS sooner are needed.
著者
Shunsuke Kawai Daisuke Kobayashi Chika Nishiyama Tomonari Shimamoto Kosuke Kiyohara Tetsuhisa Kitamura Katsuya Tanaka Kouichi Kinashi Naho Koyama Tetsuya Sakamoto Seishiro Marukawa Taku Iwami
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-23-0177, (Released:2023-11-18)
参考文献数
42
被引用文献数
1

Background: Little is known about how to effectively increase bystander cardiopulmonary resuscitation (CPR), so we evaluated the 10-year trend of the proportion of bystander CPR in an area with wide dissemination of chest compression-only CPR (CCCPR) training combined with conventional CPR training.Methods and Results: We conducted a descriptive study after a community intervention, using a prospective cohort from September 2010 to December 2019. The intervention consisted of disseminating CCCPR training combined with conventional CPR training in Toyonaka City since 2010. We analyzed all non-traumatic out-of-hospital cardiac arrest (OHCA) patients resuscitated by emergency medical service personnel. The primary outcome was the trend of the proportion of bystander CPR. We conducted multivariate logistic regression models and assessed the adjusted odds ratio (AOR) using a 95% confidence interval (CI) to determine bystander CPR trends. Since 2010, we have trained 168,053 inhabitants (41.9% of the total population of Toyonaka City). A total of 1,508 OHCA patients were included in the analysis. The proportion of bystander CPR did not change from 2010 (43.3%) to 2019 (40.0%; 1-year incremental AOR 1.02 [95% CI: 0.98–1.05]).Conclusions: The proportion of bystander CPR did not increase even after wider dissemination of CPR training. In addition to continuing wider dissemination of CPR training, other strategies such as the use of technology are necessary to increase bystander CPR.
著者
Haruka Shida Chika Nishiyama Satoe Okabayashi Yosuke Yamamoto Tomonari Shimamoto Takashi Kawamura Tetsuya Sakamoto Taku Iwami
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-21-0341, (Released:2021-11-10)
参考文献数
29
被引用文献数
8

Background:Although bystanders’ performance is important to improve outcomes of patients after cardiac arrests, few studies have investigated the barriers of bystanders, including those who could not perform cardiopulmonary resuscitation or any other rescue actions in emergency situations. This study aimed to assess the relationship between the psychological barriers of laypersons who encountered emergency situations and their rescue actions.Methods and Results:A questionnaire survey was conducted and this included laypersons who had encountered emergency situations during the last 5 years. Six questions were about the psychological barriers and 8 questions were about the laypersons’ rescue actions. The primary outcome was any rescue actions performed by laypersons in an actual emergency situation. Overall, 7,827 (92.8%) of 8,430 laypersons responded; of them, 1,361 (16.1%) had encountered emergency situations during the last 5 years, and 1,220 (14.5%) were eligible for inclusion in the analyses. Of the 6 psychological barriers, “fear of approaching a collapsed person” (adjusted odds ratio [AOR] 0.50; 95% confidence interval [95% CI] 0.32–0.79) and “difficulties in judging whether to perform any rescue action” (AOR 0.63; 95% CI 0.40–0.99) were significantly associated with performing any rescue actions.Conclusions:The fear of approaching a collapsed person and difficulties in judging whether to take any actions were identified as the psychological barriers in performing any rescue actions by laypersons who encountered emergency situations.
著者
Tetsuhisa Kitamura Kosuke Kiyohara Tasuku Matsuyama Toshihiro Hatakeyama Tomonari Shimamoto Junichi Izawa Chika Nishiyama Taku Iwami
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20150100, (Released:2015-12-05)
参考文献数
30
被引用文献数
4 10

Background: Outcomes after out-of-hospital cardiac arrests (OHCAs) might be worse during academic meetings because many medical professionals attend them.Methods: This nationwide population-based observation of all consecutively enrolled Japanese adult OHCA patients with resuscitation attempts from 2005 to 2012. The primary outcome was 1-month survival with a neurologically favorable outcome. Calendar days at three national meetings (Japanese Society of Intensive Care Medicine, Japanese Association for Acute Medicine, and Japanese Circulation Society) were obtained for each year during the study period, because medical professionals who belong to these academic societies play an important role in treating OHCA patients after hospital admission, and we identified two groups: the exposure group included OHCAs that occurred on meeting days, and the control group included OHCAs that occurred on the same days of the week 1 week before and after meetings. Multiple logistic regression analysis was used to adjust for confounding variables.Results: A total of 20 143 OHCAs that occurred during meeting days and 38 860 OHCAs that occurred during non-meeting days were eligible for our analyses. The proportion of patients with favorable neurologic outcomes after whole arrests did not differ during meeting and non-meeting days (1.6% [324/20 143] vs 1.5% [596/38 855]; adjusted odds ratio 1.02; 95% confidence interval, 0.88–1.19). Regarding bystander-witnessed ventricular fibrillation arrests of cardiac origin, the proportion of patients with favorable neurologic outcomes also did not differ between the groups.Conclusions: In this population, there were no significant differences in outcomes after OHCAs that occurred during national meetings of professional organizations related to OHCA care and those that occurred during non-meeting days.
著者
Kayo Tanigawa-Sugihara Taku Iwami Chika Nishiyama Tetsuhisa Kitamura Masashi Goto Masahiko Ando Tatsuya Nishiuchi Yasuyuki Hayashi Takashi Kawamura
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.77, no.8, pp.2073-2078, 2013 (Released:2013-07-25)
参考文献数
35
被引用文献数
11 24

Background: Weather conditions affect the occurrence of cardiovascular disease. The aim of this study was to investigate the associations between atmospheric conditions including temperature, pressure, and humidity, and the occurrence of out-of-hospital cardiac arrests (OHCAs) with cardiac etiology. Methods and Results: This study was a cross-sectional analysis of a prospective cohort that included all persons aged ≥18 years with OHCA in Osaka, from 1998 through 2007. The association between the number of daily OHCA events with various atmospheric conditions was analyzed using Poisson regression. A total of 28,806 adult OHCAs were presumed to be of cardiac etiology. The number of OHCAs in 1 day was inversely correlated with the day’s mean atmospheric temperature. The regression coefficient was greater on the days under 18°C (r=–0.317, P<0.001) than on days over 18°C (r=–0.088, P<0.001). A positive linear relation was found between the number of OHCAs in 1 day and the day’s mean atmospheric pressure (r=0.321, P<0.001). Under 18°C, every 5°C decrease in the daily mean temperature was associated with an 11% (95% confidence interval [CI]: 8–13%) increase in OHCA occurrence in the non-elderly group, and a 16% increase in the elderly group (95% CI: 14–19%). Conclusions: The occurrence of adult OHCA with cardiac etiology increases with decreasing temperature of the day. Elderly people are more susceptible to severe weather conditions.  (Circ J 2013; 77: 2073–2078)