Abstract 48: Incidence, Outcome and Characteristics of Cardiac Arrest at Schools
Background Although automated external defibrillators (AEDs) are widely prevalent in public places in Japan, the impact of implementing AEDs at schools remains unclear.
Objectives To clarify the incidence, outcomes, and characteristics of out-of-hospital cardiac arrest (OHCA) at schools.
Methods The Utstein Osaka Project is a population-based cohort study aimed at identifying the incidence and outcomes of OHCA in Osaka (population of 8.8 million), Japan. From the data collected according to the Utstein Recommendations, we extracted cases of OHCA at schools between Jan. 1, 2005 and Dec. 31, 2009. In this study, the term “school” included all educational institutions defined by the Japanese School Education Act. Primary outcome measures were one-month survival and good neurological outcome, as defined as Cerebral Performance Category 1 or 2.
Results During the study period, 34 cases of non-traumatic OHCA occurred at schools among the total of 33,901 registered OHCA cases. Of these 34 cases, 14 (41%) patients achieved one-month survival and 11 patients (32%) had good neurological outcome. A total of 23 (68%) patients, which consisted of 10 students, 4 school officials, and 9 adults not affiliated with schools, presented ventricular fibrillation (VF) as the first monitored rhythm. Of the patients presenting with VF, 12 (52%) survived one month after cardiac arrest and 10 (43%) had good neurological outcome. Twelve of the patients had a history of cardiac disease, with seven collapsing during physical exercise. An additional five patients without a history of cardiac disease experienced OHCA with VF during exercise. Citizen rescuers applied AED pads to ten patients and administered electrical shocks to five patients, with three of these patients surviving without neurological deficits.
Conclusions Approximately 70% of the OHCA patients at schools presented VF as the first monitored rhythm. Most were students or adults with either a past history of cardiac disease or who were performing physical exercise. The characteristics of OHCA cases revealed in this study should be taken into consideration when creating and implementing medical emergency response plans for cardiac arrest at schools in Japan.
- © 2011 by American Heart Association, Inc.