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

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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 87

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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

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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

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

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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)