Abstract 16556: Predictors of Neurological Outcome After Out-of-Hospital Cardiac Arrest With Ventricular Fibrillation Witnessed by Emergency Medical Service Personnel
Background: Effective advanced life support is one of the important link in the chain of survival. In Japan, the emergency medical service (EMS) personnel can perform defibrillation, advanced airway management, intravenous access and administration of epinephrine as an advanced life support intervention for the treatment of out-of-hospital cardiac arrest (OHCA). However, whether these interventions performed by EMS improves neurological outcomes remains unclear.
Objective: To evaluate predictors of favorable neurological outcome in patients suffering OHCA with ventricular fibrillation (VF) witnessed by an EMS personnel.
Methods: The Fire and Disaster Management Agency (FDMA) of Japan developed a nationwide database of a prospective population-based cohort using an Utstein-style template for OHCA patients since January 2005. To evaluate data after the publication of Guideline2005, data from January 2006 to December 2014 of this database was used for the current analysis. A multivariate logistic-regression analysis was performed to assess factors associated with favorable neurological outcome (defined as Cerebral Performance Category 1 or 2) 1 month after cardiac arrest.
Results: Of the 1,073,625 patients documented for the study period, 1371 adult patients with an OHCA of cardiac origin and VF for the initial rhythm witnessed by an EMS personnel were included in the present analysis. The overall mortality was 59%. Rate of return of spontaneous circulation and favorable neurological outcome were 40% and 31%, respectively. Higher age (OR0.976, 95%CI0.968-0.985, p<0.001), delayed defibrillation (OR0.895, 95%CI0.850-0.942, p<0.001), advanced airway management (OR0.0.229, 95%CI0.214-0.418, p<0.001), administration of epinephrine (OR0.481, 95%CI0.250-0.921, p=0.027) and multiple attempts of defibrillation (OR0.837, 95%CI0.763-0.919, p<0.001) were negatively associated with favorable neurological outcome.
Conclusion: In patients with VF witnessed by EMS personnel, resuscitation efforts should simply focus on early defibrillation and CPR without advanced interventions.
Author Disclosures: K. Hashiba: None. Y. Tahara: None. J. Matsumoto: None. K. Kimura: None. S. Yasuda: None. S. Kojima: None. H. Ogawa: None. N. Yonemoto: None. K. Saku: None. H. Nonogi: None. K. Nagao: None.
- © 2016 by American Heart Association, Inc.