Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: Nationwide cohort study

Izawa, Junichi; Komukai, Sho; Gibo, Koichiro; Okubo, Masashi; Kiyohara, Kosuke; Nishiyama, Chika; Kiguchi, Takeyuki; Matsuyama, Tasuku; Kawamura, Takashi; Iwami, Taku; Callaway, Clifton W.; Kitamura, Tetsuhisa

doi:https://doi.org/10.1136/bmj.l430

Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: Nationwide cohort study

Izawa, Junichi; Komukai, Sho; Gibo, Koichiro et al.

BMJ (Online), 2019, 364

Number of Access:1,106（2025-12-11 22:39 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/78389

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Title	Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: Nationwide cohort study
Creator	CreatorName Izawa, Junichi
	NRID 1000070794543 1000070794543 ORCID 0000-0002-4329-2520 0000-0002-4329-2520 researchmap permalink sho.komukai sho.komukai Scopus Author ID 57200127087 57200127087 CreatorName Komukai, Sho
	CreatorName Gibo, Koichiro
	CreatorName Okubo, Masashi
	NRID 1000080581834 1000080581834 CreatorName Kiyohara, Kosuke
	NRID 1000040584842 1000040584842 CreatorName Nishiyama, Chika
	NRID 1000030724380 1000030724380 CreatorName Kiguchi, Takeyuki
	NRID 1000050829025 1000050829025 CreatorName Matsuyama, Tasuku
	NRID 1000010252230 1000010252230 CreatorName Kawamura, Takashi
	NRID 1000060437291 1000060437291 CreatorName Iwami, Taku
	CreatorName Callaway, Clifton W.
	NRID 1000030639810 1000030639810 ORCID 0000-0003-0107-0580 0000-0003-0107-0580 researchmap permalink Kitamura_T Kitamura_T Scopus Author ID 22234282700 22234282700 CreatorName Kitamura, Tetsuhisa
Description	Izawa Junichi, Komukai Sho, Gibo Koichiro, Okubo Masashi, Kiyohara Kosuke, Nishiyama Chika et al. Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: nationwide cohort study. BMJ 2019; 364 :l430
Abstract	Objective To determine survival associated with advanced airway management (AAM) compared with no AAM for adults with out-of-hospital cardiac arrest. Design Cohort study between January 2014 and December 2016. Setting Nationwide, population based registry in Japan (All-Japan Utstein Registry). Participants Consecutive adult patients with out-of-hospital cardiac arrest, separated into two sub-cohorts by their first documented electrocardiographic rhythm: shockable (ventricular fibrillation or pulseless ventricular tachycardia) and non-shockable (pulseless electrical activity or asystole). Patients who received AAM during cardiopulmonary resuscitation were sequentially matched with patients at risk of AAM within the same minute on the basis of time dependent propensity scores. Main outcome measures Survival at one month or at hospital discharge within one month. Results Of the 310 620 patients eligible, 8459 (41.2%) of 20 516 in the shockable cohort and 121 890 (42.0%) of 290 104 in the non-shockable cohort received AAM during cardiopulmonary resuscitation. After time dependent propensity score sequential matching, 16 114 patients in the shockable cohort and 236 042 in the non-shockable cohort were matched at the same minute. In the shockable cohort, survival did not differ between patients with AAM and those with no AAM: 1546/8057 (19.2%) versus 1500/8057 (18.6%) (adjusted risk ratio 1.00, 95% confidence interval 0.93 to 1.07). In the non-shockable cohort, patients with AAM had better survival than those with no AAM: 2696/118 021 (2.3%) versus 2127/118 021 (1.8%) (adjusted risk ratio 1.27, 1.20 to 1.35). Conclusions In the time dependent propensity score sequential matching for out-of-hospital cardiac arrest in adults, AAM was not associated with survival among patients with shockable rhythm, whereas AAM was associated with better survival among patients with non-shockable rhythm.
Publisher	BMJ Publishing Group
Source Title	BMJ (Online)
Volume (Issue)	364
Date of Issued	2019-02-28
Language	English
Handle URL	https://hdl.handle.net/11094/78389
PISSN	09598146
eISSN	17561833
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1136/bmj.l430
Relation.isIdenticalTo	PMID 30819685
Access Rights	open access
CopyRight	© 2019 BMJ Publishing Group Ltd. This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	BMJ (Online). 2019, 364
DC.title	Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: Nationwide cohort study
DC.creator	Izawa, Junichi
	Komukai, Sho
	Gibo, Koichiro
	Okubo, Masashi
	Kiyohara, Kosuke
	Nishiyama, Chika
	Kiguchi, Takeyuki
	Matsuyama, Tasuku
	Kawamura, Takashi
	Iwami, Taku
	Callaway, Clifton W.
	Kitamura, Tetsuhisa
DC.publisher	BMJ Publishing Group
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2019-02-28
DC.identifier	https://doi.org/10.1136/bmj.l430
DC.description	Izawa Junichi, Komukai Sho, Gibo Koichiro, Okubo Masashi, Kiyohara Kosuke, Nishiyama Chika et al. Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: nationwide cohort study. BMJ 2019; 364 :l430
DCTERMS.abstract	Objective To determine survival associated with advanced airway management (AAM) compared with no AAM for adults with out-of-hospital cardiac arrest. Design Cohort study between January 2014 and December 2016. Setting Nationwide, population based registry in Japan (All-Japan Utstein Registry). Participants Consecutive adult patients with out-of-hospital cardiac arrest, separated into two sub-cohorts by their first documented electrocardiographic rhythm: shockable (ventricular fibrillation or pulseless ventricular tachycardia) and non-shockable (pulseless electrical activity or asystole). Patients who received AAM during cardiopulmonary resuscitation were sequentially matched with patients at risk of AAM within the same minute on the basis of time dependent propensity scores. Main outcome measures Survival at one month or at hospital discharge within one month. Results Of the 310 620 patients eligible, 8459 (41.2%) of 20 516 in the shockable cohort and 121 890 (42.0%) of 290 104 in the non-shockable cohort received AAM during cardiopulmonary resuscitation. After time dependent propensity score sequential matching, 16 114 patients in the shockable cohort and 236 042 in the non-shockable cohort were matched at the same minute. In the shockable cohort, survival did not differ between patients with AAM and those with no AAM: 1546/8057 (19.2%) versus 1500/8057 (18.6%) (adjusted risk ratio 1.00, 95% confidence interval 0.93 to 1.07). In the non-shockable cohort, patients with AAM had better survival than those with no AAM: 2696/118 021 (2.3%) versus 2127/118 021 (1.8%) (adjusted risk ratio 1.27, 1.20 to 1.35). Conclusions In the time dependent propensity score sequential matching for out-of-hospital cardiac arrest in adults, AAM was not associated with survival among patients with shockable rhythm, whereas AAM was associated with better survival among patients with non-shockable rhythm.
DC.rights	© 2019 BMJ Publishing Group Ltd. This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
DC.format	78389
citation_title	Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: Nationwide cohort study
citation_author	Izawa, Junichi
	Komukai, Sho
	Gibo, Koichiro
	Okubo, Masashi
	Kiyohara, Kosuke
	Nishiyama, Chika
	Kiguchi, Takeyuki
	Matsuyama, Tasuku
	Kawamura, Takashi
	Iwami, Taku
	Callaway, Clifton W.
	Kitamura, Tetsuhisa
citation_publisher	BMJ Publishing Group
citation_language	English
citation_date	2019-02-28
citation_journal_title	BMJ (Online)
citation_volume	364
citation_doi	https://doi.org/10.1136/bmj.l430
citation_pmid	30819685
citation_public_url	https://hdl.handle.net/11094/78389

Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: Nationwide cohort study

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