BMC Anesthesiology (Apr 2017)

Association between cardiopulmonary resuscitation duration and one-month neurological outcomes for out-of-hospital cardiac arrest: a prospective cohort study

  • Masahiro Kashiura,
  • Yuichi Hamabe,
  • Akiko Akashi,
  • Atsushi Sakurai,
  • Yoshio Tahara,
  • Naohiro Yonemoto,
  • Ken Nagao,
  • Arino Yaguchi,
  • Naoto Morimura,
  • on behalf of the SOS-KANTO 2012 Study Group

DOI
https://doi.org/10.1186/s12871-017-0351-1
Journal volume & issue
Vol. 17, no. 1
pp. 1 – 8

Abstract

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Abstract Background The duration of cardiopulmonary resuscitation (CPR) is an important factor associated with the outcomes for an out-of-hospital cardiac arrest. However, the appropriate CPR duration remains unclear considering pre- and in-hospital settings. The present study aimed to evaluate the relationship between the CPR duration (including both the pre- and in-hospital duration) and neurologically favorable outcomes 1-month after cardiac arrest. Methods Data were utilized from a prospective multi-center cohort study of out-of-hospital cardiac arrest patients transported to 67 emergency hospitals between January 2012 and March 2013 in the Kanto area of Japan. A total of 3,353 patients with out-of-hospital cardiac arrest (age ≥18 years) who underwent CPR by emergency medical service personnel and achieved the return of spontaneous circulation in a pre- or in-hospital setting were analyzed. The primary outcome was a 1-month favorable neurological outcome. Logistic regression analysis was performed to estimate the influence of cardiopulmonary resuscitation duration. The CPR duration that achieved a cumulative proportion >99% of cases with a 1-month neurologically favorable outcome was determined. Results Of the 3,353 eligible cases, pre-hospital return of spontaneous circulation was obtained in 1,692 cases (50.5%). A total of 279 (8.3%) cases had a 1-month neurologically favorable outcome. The CPR duration was significantly and inversely associated with 1-month neurologically favorable outcomes with adjustment for pre- and in-hospital confounders (adjusted odds ratio: 0.911, per minute, 95% CI: 0.892–0.929, p 99%. Conclusions The CPR duration was independently and inversely associated with 1-month neurologically favorable outcomes after out-of-hospital cardiac arrest. The CPR duration required to achieve return of spontaneous circulation in >99% of out-of-hospital cardiac arrest patients with a 1-month favorable neurological outcome was 45 min, considering both pre- and in-hospital settings.

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