Benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest: a community-based, observational study in Niigata, Japan
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Open Access
Abstract
Objective This study aimed to assess the benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest using a community-based registry. Design Population-based, retrospective cohort study. Setting An urban city with approximately 800 000 residents. Participants Patients aged ≥18 years with bystander-witnessed out-of-hospital cardiac arrests of medical aetiology in Niigata City, Japan, between January 2012 and December 2016, according to the Utstein style. Primary and secondary outcome measures The primary outcome was 1-month survival with a favourable neurological outcome, defined as a cerebral performance category score of 1 or 2. We used logistic regression analysis to assess the association between favourable neurological outcome and prehospital physician involvement. Results During the study period, a total of 4172 cardiac arrests were registered; of these, 892 patients with out-of-hospital cardiac arrest were eligible for this analysis, among whom 135 (15.1%) had prehospital physician involvement and 757 (84.9%) did not have prehospital physician involvement. The percentage of favourable neurological outcomes was 20.7% (28 of 135) in those with physician involvement and 10.4% (79 of 757) in those without physician involvement (p=0.001). Using multivariable logistic regression, prehospital physician involvement had an OR for a favourable neurological outcome of 3.44 (95% CI 1.64 to 7.23). Conclusions Among adults with out-of-hospital cardiac arrest, adding a physician-staffed ambulance was associated with significantly greater favourable neurological outcomes than standard emergency medical services.Keywords
This publication has 30 references indexed in Scilit:
- Impact of prehospital physician-led cardiopulmonary resuscitation on neurologically intact survival after out-of-hospital cardiac arrest: A nationwide population-based observational studyResuscitation, 2019
- Influence of EMS-physician presence on survival after out-of-hospital cardiopulmonary resuscitation: systematic review and meta-analysisCritical Care, 2015
- Part 4: Systems of Care and Continuous Quality ImprovementCirculation, 2015
- The time dependent association of adrenaline administration and survival from out-of-hospital cardiac arrestResuscitation, 2015
- Cardiac Arrest and Cardiopulmonary Resuscitation Outcome Reports: Update of the Utstein Resuscitation Registry Templates for Out-of-Hospital Cardiac ArrestCirculation, 2015
- Impact of the number of on-scene emergency life-saving technicians and outcomes from out-of-hospital cardiac arrest in Osaka CityResuscitation, 2014
- Collaborative effects of bystander-initiated cardiopulmonary resuscitation and prehospital advanced cardiac life support by physicians on survival of out-of-hospital cardiac arrest: a nationwide population-based observational studyCritical Care, 2010
- Emergency medical service systems in Japan: Past, present, and futureResuscitation, 2006
- Cardiac Arrest and Cardiopulmonary Resuscitation Outcome ReportsCirculation, 2004
- Quality of on-site performance in prehospital advanced cardiac life support (ACLS)Resuscitation, 1994