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An Utstein-style Investigation into the Association between Prognoses and the Conditions of Patients with Out-of-hospital Cardiac Arrest



Objective: The goal of this study was to evaluate the association between the conditions of the patients at the time of the emergency calls (119) and their prognoses.

Methods: A total of 1511 cases from the records of the Emergency Medical Services from July 1, 2010 to September 30, 2012 were retrospectively investigated using the Utstein Style. The presence of consciousness, pulse and respiration were evaluated to confirm the clinical conditions of the patients. The conscious cases, at the time of the emergency calls, were further classified into groups based on their chief complaints. To evaluate the association between the conditions of the patients and their prognoses, each condition was compared with unconscious cases without respiration.

Results: The one-month survival rate was significantly higher in conscious cases with chest pain/back pain or dyspnoea, conscious cases with faint state, unconscious cases with respiration, unconscious cases with respiration unknown, and unconscious cases with seizure at the time of the emergency calls (p < 0.001, p = 0.004, p < 0.001, p = 0.042 and p = 0.001, respectively). In multivariate analysis, conscious cases with chest/back pain or dyspnoea (odds ratio (OR) = 9.298, 95% confidence level (95% CI) = 4.373, 19.768), unconscious cases with respiration (OR = 3.884, 95% CI = 2.166, 6.964), and unconscious cases with breathing unknown (OR = 1.915, 95% CI = 1.129, 3.247) were significant prognostic factors.

Conclusion: The subsequent survival rate was particularly high in cases with chest/back pain or dyspnoea, and cases in which the bystander could not confirm respiratory arrest. It is pivotal to provide appropriate instructions on resuscitation, without overlooking important signs that have an impact on survival in these cases. 

February 13, 2017
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