In-hospital extracorporeal cardiopulmonary resuscitation for patients with out-of-hospital cardiac arrest: an analysis by time-dependent propensity score matching using a nationwide database in Japan
-
- Okada, Yohei
- Department of Preventive Services, School of Public Health/Graduate School of Medicine, Kyoto University; Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore
-
- Komukai, Sho
- Division of Biomedical Statistics, Department of Integrated Medicine, Graduate School of Medicine, Osaka University
-
- Irisawa, Taro
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine
-
- Yamada, Tomoki
- Emergency and Critical Care Medical Center, Osaka Police Hospital
-
- Yoshiya, Kazuhisa
- Department of Emergency and Critical Care Medicine, Kansai Medical University, Takii Hospital
-
- Park, Changhwi
- Department of Emergency Medicine, Tane General Hospital
-
- Nishimura, Tetsuro
- Department of Critical Care Medicine, Osaka City University
-
- Ishibe, Takuya
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, Kindai University
-
- Kobata, Hitoshi
- Osaka Mishima Emergency Critical Care Center
-
- Kiguchi, Takeyuki
- Critical Care and Trauma Center, Osaka General Medical Center
-
- Kishimoto, Masafumi
- Osaka Prefectural Nakakawachi Medical Center of Acute Medicine
-
- Kim, Sung-Ho
- Senshu Trauma and Critical Care Center
-
- Ito, Yusuke
- Senri Critical Care Medical Center, Saiseikai Senri Hospital
-
- Sogabe, Taku
- Traumatology and Critical Care Medical Center, National Hospital Organization Osaka National Hospital
-
- Morooka, Takaya
- Emergency and Critical Care Medical Center, Osaka City General Hospital
-
- Sakamoto, Haruko
- Department of Pediatrics, Osaka Red Cross Hospital
-
- Suzuki, Keitaro
- Emergency and Critical Care Medical Center, Kishiwada Tokushukai Hospital
-
- Onoe, Atsunori
- Department of Emergency and Critical Care Medicine, Kansai Medical University
-
- Matsuyama, Tasuku
- Department of Emergency Medicine, Kyoto Prefectural University of Medicine
-
- Nishioka, Norihiro
- Department of Preventive Services, School of Public Health/Graduate School of Medicine, Kyoto University
-
- Matsui, Satoshi
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University
-
- Yoshimura, Satoshi
- Department of Preventive Services, School of Public Health/Graduate School of Medicine, Kyoto University
-
- Kimata, Shunsuke
- Department of Preventive Services, School of Public Health/Graduate School of Medicine, Kyoto University
-
- Kawai, Shunsuke
- Department of Preventive Services, School of Public Health/Graduate School of Medicine, Kyoto University
-
- Makino, Yuto
- Department of Preventive Services, School of Public Health/Graduate School of Medicine, Kyoto University
-
- Kiyohara, Kosuke
- Department of Food Science Faculty of Home Economics, Otsuma Women's University
-
- Zha, Ling
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University
-
- Ong, Marcus Eng Hock
- Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore; Department of Emergency Medicine, Singapore General Hospital
-
- Iwami, Taku
- Department of Preventive Services, School of Public Health/Graduate School of Medicine, Kyoto University
-
- Kitamura, Tetsuhisa
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University
Abstract
BACKGROUND: Extracorporeal cardiopulmonary resuscitation (ECPR) has been proposed as a rescue therapy for patients with refractory cardiac arrest. This study aimed to evaluate the association between ECPR and clinical outcomes among patients with out-of-hospital cardiac arrest (OHCA) using risk-set matching with a time-dependent propensity score. METHODS: This was a secondary analysis of the JAAM-OHCA registry data, a nationwide multicenter prospective study of patients with OHCA, from June 2014 and December 2019, that included adults (≥ 18years) with OHCA. Initial cardiac rhythm was classified as shockable and non-shockable. Patients who received ECPR were sequentially matched with the control, within the same time (minutes) based on time-dependent propensity scores calculated from potential confounders. The odds ratios with 95% confidence intervals (CI) for 30-day survival and 30-day favorable neurological outcomes were estimated for ECPR cases using a conditional logistic model. RESULTS: Of 57, 754 patients in the JAAM-OHCA registry, we selected 1826 patients with an initial shockable rhythm (treated with ECPR, n = 913 and control, n = 913) and a cohort of 740 patients with an initial non-shockable rhythm (treated with ECPR, n = 370 and control, n = 370). In these matched cohorts, the odds ratio for 30-day survival in the ECPR group was 1.76 [95%CI 1.38-2.25] for shockable rhythm and 5.37 [95%CI 2.53-11.43] for non-shockable rhythm, compared to controls. For favorable neurological outcomes, the odds ratio in the ECPR group was 1.11 [95%CI 0.82-1.49] for shockable rhythm and 4.25 [95%CI 1.43-12.63] for non-shockable rhythm, compared to controls. CONCLUSION: ECPR was associated with increased 30-day survival in patients with OHCA with initial shockable and even non-shockable rhythms. Further research is warranted to investigate the reproducibility of the results and who is the best candidate for ECPR.
Journal
-
- Critical Care
-
Critical Care 27 2023-11-15
Springer Nature
- Tweet
Keywords
Details 詳細情報について
-
- CRID
- 1050861228446706048
-
- ISSN
- 13648535
-
- HANDLE
- 2433/286142
-
- Text Lang
- en
-
- Article Type
- journal article
-
- Data Source
-
- IRDB