Kentaro Kajino1, Tetsuhisa Kitamura2, Taku Iwami3, Mohamud Daya4, Marcus Eng Hock Ong5, Chika Nishiyama6, Tomohiko Sakai7, Kayo Tanigawa-Sugihara3, Sumito Hayashida8, Tatsuya Nishiuchi9, Yasuyuki Hayashi10, Atsushi Hiraide11, Takeshi Shimazu12. 1. Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamada-Oka, Suita City, Osaka 565-0871, Japan. Electronic address: kajihanapu@yahoo.co.jp. 2. Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, 2-5 Yamada-oka, Suita, Osaka 565-0871, Japan. 3. Kyoto University, Health Services, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, Japan. 4. Department of Emergency Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mail Code CD-EM, Portland, OR 97239-3098, USA. 5. Department of Emergency Medicine, Singapore General Hospital, Outram Road, Singapore 169608, Singapore. 6. Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Knoecho, Sakyo-ku, Kyoto 606-8501, Japan. 7. Department of Trauma and Critical Care Medicine and Burn Centers, Social Insurance Chukyo Hospital, 1-1-10 Sanjyo Minamiku, Nagoya, Aichi 457-8510, Japan. 8. Osaka Municipal Fire Department, 1-12-54 Kujo minami, Nishi-ku, Osaka 550-8566, Japan. 9. Department of Critical Care and Emergency Medicine, Osaka City University Graduate School of Medicine, 1-5-17 Asahimachi, Abeno-ku, Osaka 545-8585, Japan. 10. Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital, 1-1-6, Tsukumodai, Suita, Osaka 565-0862, Japan. 11. Department of acute Medicine, Kinki University Faculty of Medicine, 377-2 Ouno higashi Osaka-Sayama, Osaka 589-8511, Japan. 12. Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamada-Oka, Suita City, Osaka 565-0871, Japan.
Abstract
BACKGROUNDS: In Japan, ambulance staffing for cardiac arrest responses consists of a 3-person unit with at least one emergency life-saving technician (ELST). Recently, the number of ELSTs on ambulances has increased since it is believed that this improves the quality of on-scene care leading to better outcomes from out-of-hospital cardiac arrest (OHCA). The objective of this study was to evaluate the association between the number of on-scene ELSTs and OHCA outcome. METHODS: This was a prospective cohort study of all bystander-witnessed OHCA patients aged ≥ 18 years in Osaka City from January 2005 to December 2007 using on an Utstein-style database. The primary outcome measure was one-month survival with favorable neurological outcome defined as a cerebral performance category ≤ 2. Multivariable logistic regression model were used to assess the contribution of the number of on-scene ELSTs to the outcome after adjusting for confounders. RESULTS: Of the 2408 bystander-witnessed OHCA patients, one ELST group was present in 639 (26.5%), two ELST were present in 1357 (56.4%), and three ELST group in 412 (17.1%). The three ELST group had a significantly higher rate of one-month survival with favorable neurological outcome compared with the one ELST group (8.0% versus 4.5%, adjusted OR 2.26, 95% CI 1.27-4.04), while the two ELST group did not (5.4% versus 4.5%, adjusted OR 1.34, 95% CI 0.82-2.19). CONCLUSIONS: Compared with the one on-scene ELST group, the three on-scene ELST group was associated with the improved one-month survival with favorable neurological outcome from OHCA in Osaka City.
BACKGROUNDS: In Japan, ambulance staffing for cardiac arrest responses consists of a 3-person unit with at least one emergency life-saving technician (ELST). Recently, the number of ELSTs on ambulances has increased since it is believed that this improves the quality of on-scene care leading to better outcomes from out-of-hospital cardiac arrest (OHCA). The objective of this study was to evaluate the association between the number of on-scene ELSTs and OHCA outcome. METHODS: This was a prospective cohort study of all bystander-witnessed OHCA patients aged ≥ 18 years in Osaka City from January 2005 to December 2007 using on an Utstein-style database. The primary outcome measure was one-month survival with favorable neurological outcome defined as a cerebral performance category ≤ 2. Multivariable logistic regression model were used to assess the contribution of the number of on-scene ELSTs to the outcome after adjusting for confounders. RESULTS: Of the 2408 bystander-witnessed OHCA patients, one ELST group was present in 639 (26.5%), two ELST were present in 1357 (56.4%), and three ELST group in 412 (17.1%). The three ELST group had a significantly higher rate of one-month survival with favorable neurological outcome compared with the one ELST group (8.0% versus 4.5%, adjusted OR 2.26, 95% CI 1.27-4.04), while the two ELST group did not (5.4% versus 4.5%, adjusted OR 1.34, 95% CI 0.82-2.19). CONCLUSIONS: Compared with the one on-scene ELST group, the three on-scene ELST group was associated with the improved one-month survival with favorable neurological outcome from OHCA in Osaka City.
Authors: Pin-Hui Fang; Yu-Yuan Lin; Chien-Hsin Lu; Ching-Chi Lee; Chih-Hao Lin Journal: Int J Environ Res Public Health Date: 2020-03-16 Impact factor: 3.390