タナカ　リョウジロウ   Ryojiro Tanaka   田中　亮二郎    所属   川崎医科大学  医学部 臨床医学　小児科学    職種   特任教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Location of arrest and survival from out-of-hospital cardiac arrest among children in the public-access defibrillation era in Japan.
掲載誌名	正式名：Resuscitation 略　 称：Resuscitation ISSNコード：18731570/03009572
掲載区分	国外
巻・号・頁	140,pp.150-158
著者・共著者	Satoshi Matsui, Tetsuhisa Kitamura, Junya Sado, Kosuke Kiyohara, Daisuke Kobayashi, Takeyuki Kiguchi, Chika Nishiyama, Satoe Okabayashi, Tomonari Shimamoto, Tasuku Matsuyama, Takashi Kawamura, Taku Iwami, Ryojiro Tanaka, Hiroshi Kurosawa, Masahiko Nitta, Tomotaka Sobue
発行年月	2019/07
概要	BACKGROUND:Our objective was to assess the characteristics such as public-access defibrillation (PAD) by laypersons and the outcomes after pediatric out-of-hospital cardiac arrest by location in the PAD era.METHODS:From a nationwide, prospective, population-based registry of out-of-hospital cardiac arrest patients in Japan, we enrolled consecutive pediatric patients aged ≤17 years before emergency medical service (EMS) arrival between 2013 and 2015. The primary outcome measure was 1-month survival, with favorable neurologic outcome defined as cerebral performance category 1 or 2. Factors associated with favorable neurologic outcome were assessed using multivariable logistic regression analysis.RESULTS:Among 3991 eligible pediatric out-of-hospital cardiac arrests, the proportion of PAD was 0.2% (5/2888) at residence, 1.6% (2/125) in public areas, 0.9% (3/321) on streets/highways, 21.6% (11/51) at recreation/sports event areas, 46.1% (82/178) at education institutions, and 1.2% (5/428) in others. In the multivariable analysis, arrest witnessed by family members (adjusted odds ratio [AOR], 5.25; 95% confidence interval [CI], 3.22-8.58) and nonfamily members (AOR, 2.45; 95% CI, 1.26-4.77), first documented ventricular fibrillation (AOR, 12.29; 95% CI, 7.08-21.35), PAD (AOR, 2.63; 95% CI, 1.23-5.62), and earlier EMS response time (AOR for 1-min increment, 0.88; 95% CI, 0.81-0.94) were associated with improving outcome. As for locations, recreation/sports event areas (AOR, 3.43; 95% CI, 1.17-10.07) and education institutions (AOR, 3.03; 95% CI, 1.39-6.63) were also associated with favorable neurologic outcome.CONCLUSIONS:In Japan, where public-access automated external defibrillators are well disseminated, characteristics such as PAD and outcomes for pediatric out-of-hospital cardiac arrest before EMS arrival differed substantially by location.
DOI	10.1016/j.resuscitation.2019.04.045
PMID	31075289