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 89

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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

Yohei Okada Sho Komukai Tetsuhisa Kitamura Takeyuki Kiguchi Taro Irisawa Tomoki Yamada Kazuhisa Yoshiya Changhwi Park Tetsuro Nishimura Takuya Ishibe Yoshiki Yagi Masafumi Kishimoto Toshiya Inoue Yasuyuki Hayashi Taku Sogabe Takaya Morooka Haruko Sakamoto Keitaro Suzuki Fumiko Nakamura Tasuku Matsuyama Norihiro Nishioka Daisuke Kobayashi Satoshi Matsui Atsushi Hirayama Satoshi Yoshimura Shunsuke Kimata Takeshi Shimazu Shigeru Ohtsuru Taku Iwami

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0675, (Released:2021-11-02)

参考文献数

52

被引用文献数

10

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Background:The hypothesis of this study is that latent class analysis could identify the subphenotypes of out-of-hospital cardiac arrest (OHCA) patients associated with the outcomes and allow us to explore heterogeneity in the effects of extracorporeal cardiopulmonary resuscitation (ECPR).Methods and Results:This study was a retrospective analysis of a multicenter prospective observational study (CRITICAL study) of OHCA patients. It included adult OHCA patients with initial shockable rhythm. Patients from 2012 to 2016 (development dataset) were included in the latent class analysis, and those from 2017 (validation dataset) were included for evaluation. The association between subphenotypes and outcomes was investigated. Further, the heterogeneity of the association between ECPR implementation and outcomes was explored. In the study results, a total of 920 patients were included for latent class analysis. Three subphenotypes (Groups 1, 2, and 3) were identified, mainly characterized by the distribution of partial pressure of O2(PO2), partial pressure of CO2(PCO2) value of blood gas assessment, cardiac rhythm on hospital arrival, and estimated glomerular filtration rate. The 30-day survival outcomes were varied across the groups: 15.7% in Group 1; 30.7% in Group 2; and 85.9% in Group 3. Further, the association between ECPR and 30-day survival outcomes by subphenotype groups in the development dataset was as varied. These results were validated using the validation dataset.Conclusions:The latent class analysis identified 3 subphenotypes with different survival outcomes and potential heterogeneity in the effects of ECPR.

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

Satoshi Yoshimura Atsushi Hirayama Takeyuki Kiguchi Taro Irisawa Tomoki Yamada Kazuhisa Yoshiya Changhwi Park Tetsuro Nishimura Takuya Ishibe Yoshiki Yagi Masafumi Kishimoto Toshiya Inoue Yasuyuki Hayashi Taku Sogabe Takaya Morooka Haruko Sakamoto Keitaro Suzuki Fumiko Nakamura Tasuku Matsuyama Yohei Okada Norihiro Nishioka Daisuke Kobayashi Satoshi Matsui Shunsuke Kimata Takeshi Shimazu Tetsuhisa Kitamura Taku Iwami on behalf of the CRITICAL Study Group Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-1022, (Released:2021-02-02)

参考文献数

38

被引用文献数

6

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Background:The aim of our study was to investigate in detail the temporal trends in in-hospital characteristics, actual management, and survival, including neurological status, among adult out-of-hospital cardiac arrest (OHCA) patients in recent years.Methods and Results:From the prospective database of the Comprehensive Registry of Intensive Care for OHCA Survival (CRITICAL) study in Osaka, Japan, we enrolled all OHCA patients aged ≥18 years for whom resuscitation was attempted, and who were transported to participating hospitals between the years 2013 and 2017. The primary outcome measure was 1-month survival with favorable neurological outcome after OHCA. Temporal trends in in-hospital management and favorable neurological outcome among adult OHCA patients were assessed. Of the 11,924 patients in the database, we included a total of 10,228 adult patients from 16 hospitals. As for in-hospital advanced treatments, extracorporeal cardiopulmonary resuscitation (ECPR) use increased from 2.4% in 2013 to 4.3% in 2017 (P for trend <0.001). However, the proportion of adult OHCA patients with favorable neurological outcome did not change during the study period (from 5.7% in 2013 to 4.4% in 2017, adjusted odds ratio (OR) for 1-year increment: 0.98 (95% confidence interval: 0.94–1.23)).Conclusions:In this target population, in-hospital management such as ECPR increased slightly between 2013 and 2017, but 1-month survival with favorable neurological outcome after adult OHCA did not improve significantly.

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)