Public-access defibrillation and out-of-hospital cardiac arrest in Japan

Kitamura, Tetsuhisa; Kiyohara, Kosuke; Sakai, Tomohiko; Matsuyama, Tasuku; Hatakeyama, Toshihiro; Shimamoto, Tomonari; Izawa, Junichi; Fujii, Tomoko; Nishiyama, Chika; Kawamura, Takashi; Iwami, Taku

doi:https://doi.org/10.1056/NEJMsa1600011

Public-access defibrillation and out-of-hospital cardiac arrest in Japan

Kitamura, Tetsuhisa; Kiyohara, Kosuke; Sakai, Tomohiko et al.

New England Journal of Medicine, 2016, 375(17), 1649-1659

Number of Access:1,249（2025-10-21 16:00 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/78401

Link to primary information

File	Format	Terms of use	Size	Views	Date.Available	Description	information
NewEnglJMed_375_17_1649	pdf	None	303 KB	875	2021.02.02

Item Information

Output File Export EndNote Basic Export Mendeley

Title	Public-access defibrillation and out-of-hospital cardiac arrest in Japan
Creator	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
	NRID 1000080581834 1000080581834 CreatorName Kiyohara, Kosuke
	NRID 1000050456985 1000050456985 researchmap permalink sakaitomohiko sakaitomohiko Scopus Author ID 35746769000 35746769000 CreatorName Sakai, Tomohiko
	NRID 1000050829025 1000050829025 CreatorName Matsuyama, Tasuku
	CreatorName Hatakeyama, Toshihiro
	NRID 1000010828411 1000010828411 CreatorName Shimamoto, Tomonari
	CreatorName Izawa, Junichi
	CreatorName Fujii, Tomoko
	NRID 1000040584842 1000040584842 CreatorName Nishiyama, Chika
	NRID 1000010252230 1000010252230 CreatorName Kawamura, Takashi
	NRID 1000060437291 1000060437291 CreatorName Iwami, Taku
Description	From N Engl J Med, Kitamura, T., Kiyohara, K., Sakai, T., Matsuyama, T., Hatakeyama, T., Shimamoto, T., Izawa, J., Fujii, T., Nishiyama, C., Kawamura, T., and Iwami, T., Public-access defibrillation and out-of-hospital cardiac arrest in Japan., 375, 17 Copyright © 2016 Massachusetts Medical Society. Reprinted with permission.
Description	Special Article
Abstract	BACKGROUND Early defibrillation plays a key role in improving survival in patients with out-ofhospital cardiac arrests due to ventricular fibrillation (ventricular-fibrillation cardiac arrests), and the use of publicly accessible automated external defibrillators (AEDs) can help to reduce the time to defibrillation for such patients. However, the effect of dissemination of public-access AEDs for ventricular-fibrillation cardiac arrest at the population level has not been extensively investigated. METHODS From a nationwide, prospective, population-based registry of patients with out-ofhospital cardiac arrest in Japan, we identified patients from 2005 through 2013 with bystander-witnessed ventricular-fibrillation arrests of presumed cardiac origin in whom resuscitation was attempted. The primary outcome measure was survival at 1 month with a favorable neurologic outcome (Cerebral Performance Category of 1 or 2, on a scale from 1 [good cerebral performance] to 5 [death or brain death]). The number of patients in whom survival with a favorable neurologic outcome was attributable to public-access defibrillation was estimated. RESULTS Of 43,762 patients with bystander-witnessed ventricular-fibrillation arrests of cardiac origin, 4499 (10.3%) received public-access defibrillation. The percentage of patients receiving public-access defibrillation increased from 1.1% in 2005 to 16.5% in 2013 (P<0.001 for trend). The percentage of patients who were alive at 1 month with a favorable neurologic outcome was significantly higher with public-access defibrillation than without public-access defibrillation (38.5% vs. 18.2%; adjusted odds ratio after propensity-score matching, 1.99; 95% confidence interval, 1.80 to 2.19). The estimated number of survivors in whom survival with a favorable neurologic outcome was attributed to public-access defibrillation increased from 6 in 2005 to 201 in 2013 (P<0.001 for trend). CONCLUSIONS In Japan, increased use of public-access defibrillation by bystanders was associated with an increase in the number of survivors with a favorable neurologic outcome after out-of-hospital ventricular-fibrillation cardiac arrest.
Publisher	Massachussetts Medical Society
Source Title	New England Journal of Medicine
Volume (Issue)	375(17)
Page	1649-1659
Date of Issued	2016-10-27
Language	English
Handle URL	https://hdl.handle.net/11094/78401
PISSN	00284793
eISSN	15334406
NCID	AA00755156
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1056/NEJMsa1600011
Relation.isIdenticalTo	PMID 27783922
Access Rights	open access
CopyRight	© 2016 Massachusetts Medical Society. Reprinted with permission.
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	New England Journal of Medicine. 2016, 375(17), p. 1649-1659
DC.title	Public-access defibrillation and out-of-hospital cardiac arrest in Japan
DC.creator	Kitamura, Tetsuhisa
	Kiyohara, Kosuke
	Sakai, Tomohiko
	Matsuyama, Tasuku
	Hatakeyama, Toshihiro
	Shimamoto, Tomonari
	Izawa, Junichi
	Fujii, Tomoko
	Nishiyama, Chika
	Kawamura, Takashi
	Iwami, Taku
DC.publisher	Massachussetts Medical Society
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2016-10-27
DC.identifier	https://doi.org/10.1056/NEJMsa1600011
DC.description	From N Engl J Med, Kitamura, T., Kiyohara, K., Sakai, T., Matsuyama, T., Hatakeyama, T., Shimamoto, T., Izawa, J., Fujii, T., Nishiyama, C., Kawamura, T., and Iwami, T., Public-access defibrillation and out-of-hospital cardiac arrest in Japan., 375, 17 Copyright © 2016 Massachusetts Medical Society. Reprinted with permission.
DC.description	Special Article
DCTERMS.abstract	BACKGROUND Early defibrillation plays a key role in improving survival in patients with out-ofhospital cardiac arrests due to ventricular fibrillation (ventricular-fibrillation cardiac arrests), and the use of publicly accessible automated external defibrillators (AEDs) can help to reduce the time to defibrillation for such patients. However, the effect of dissemination of public-access AEDs for ventricular-fibrillation cardiac arrest at the population level has not been extensively investigated. METHODS From a nationwide, prospective, population-based registry of patients with out-ofhospital cardiac arrest in Japan, we identified patients from 2005 through 2013 with bystander-witnessed ventricular-fibrillation arrests of presumed cardiac origin in whom resuscitation was attempted. The primary outcome measure was survival at 1 month with a favorable neurologic outcome (Cerebral Performance Category of 1 or 2, on a scale from 1 [good cerebral performance] to 5 [death or brain death]). The number of patients in whom survival with a favorable neurologic outcome was attributable to public-access defibrillation was estimated. RESULTS Of 43,762 patients with bystander-witnessed ventricular-fibrillation arrests of cardiac origin, 4499 (10.3%) received public-access defibrillation. The percentage of patients receiving public-access defibrillation increased from 1.1% in 2005 to 16.5% in 2013 (P<0.001 for trend). The percentage of patients who were alive at 1 month with a favorable neurologic outcome was significantly higher with public-access defibrillation than without public-access defibrillation (38.5% vs. 18.2%; adjusted odds ratio after propensity-score matching, 1.99; 95% confidence interval, 1.80 to 2.19). The estimated number of survivors in whom survival with a favorable neurologic outcome was attributed to public-access defibrillation increased from 6 in 2005 to 201 in 2013 (P<0.001 for trend). CONCLUSIONS In Japan, increased use of public-access defibrillation by bystanders was associated with an increase in the number of survivors with a favorable neurologic outcome after out-of-hospital ventricular-fibrillation cardiac arrest.
DC.rights	© 2016 Massachusetts Medical Society. Reprinted with permission.
DC.format	78401
citation_title	Public-access defibrillation and out-of-hospital cardiac arrest in Japan
citation_author	Kitamura, Tetsuhisa
	Kiyohara, Kosuke
	Sakai, Tomohiko
	Matsuyama, Tasuku
	Hatakeyama, Toshihiro
	Shimamoto, Tomonari
	Izawa, Junichi
	Fujii, Tomoko
	Nishiyama, Chika
	Kawamura, Takashi
	Iwami, Taku
citation_publisher	Massachussetts Medical Society
citation_language	English
citation_date	2016-10-27
citation_journal_title	New England Journal of Medicine
citation_volume	375
citation_issue	17
citation_firstpage	1649
citation_lastpage	1659
citation_doi	https://doi.org/10.1056/NEJMsa1600011
citation_pmid	27783922
citation_public_url	https://hdl.handle.net/11094/78401

Public-access defibrillation and out-of-hospital cardiac arrest in Japan

Link to primary information

Item Information

Show details