Hospitals' extracorporeal cardiopulmonary resuscitation capabilities and outcomes in out-of-hospital cardiac arrest : A population-based study

Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved..

AIM: Extracorporeal cardiopulmonary resuscitation (ECPR) is the emerging resuscitative strategy to save refractory ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) patients. We investigated whether the receiving hospitals' ECPR capabilities are associated with outcomes in out-of-hospital cardiac arrest (OHCA) patients who have refractory VF or pulseless VT.

METHODS: In a population-based cohort study performed in Kobe City, Japan, between 2010 and 2017, we identified all OHCA patients who had refractory VF or pulseless VT. Based on their ECPR capabilities, hospitals were categorised into ECPR facilities and conventional cardiopulmonary resuscitation (CCPR) facilities. We compared patient survivals between ECPR facilities and CCPR facilities by applying inverse probability weighting using a propensity score.

RESULTS: Of all 10,971 OHCA patients, 518 had refractory VF or pulseless VT. The proportion of favourable neurologic outcomes was 43/188 (22.9%) in ECPR facilities and 28/330 (8.5%) in CCPR facilities. In the propensity analysis, hospitals' ECPR capabilities were associated with favourable neurologic outcomes (adjusted risk difference [ARD], 9.7% [95% confidence interval [CI], 3.7%-15.7%]; adjusted risk ratio [ARR], 2.01 [95% CI, 1.31-3.09]), and overall survival (87/188 [46.3%] vs. 67/330 [20.3%]; ARD, 19.0% [95% CI, 11.1%-26.9%]; ARR, 1.88 [95% CI, 1.45-2.44]).

CONCLUSIONS: Hospitals' ECPR capabilities were associated with favourable neurologic outcomes in OHCA patients who had refractory VF or pulseless VT. We should take each hospital's ECPR capability into consideration when developing a regional system of care for OHCA.

Medienart:

E-Artikel

Erscheinungsjahr:

2019

Erschienen:

2019

Enthalten in:

Zur Gesamtaufnahme - volume:136

Enthalten in:

Resuscitation - 136(2019) vom: 17. März, Seite 85-92

Sprache:

Englisch

Beteiligte Personen:

Matsuoka, Yoshinori [VerfasserIn]
Ikenoue, Tatsuyoshi [VerfasserIn]
Hata, Natsumi [VerfasserIn]
Taguri, Masataka [VerfasserIn]
Itaya, Takahiro [VerfasserIn]
Ariyoshi, Koichi [VerfasserIn]
Fukuhara, Shunichi [VerfasserIn]
Yamamoto, Yosuke [VerfasserIn]

Links:

Volltext

Themen:

Emergency medical services
Extracorporeal cardiopulmonary resuscitation
Hospital characteristics
Journal Article
Out-of-hospital cardiac arrest

Anmerkungen:

Date Completed 01.05.2020

Date Revised 01.05.2020

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.resuscitation.2019.01.013

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM292965737