Actual Situation Regarding Cardiac Etiology Determined by Clinical Diagnosis of and Medical Examiner's Postmortem Findings on Witnessed Out-of-hospital Cardiac Arrest Cases

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概要

• 論文の詳細を見る

• Aim: To examine indicators that may assist in the diagnosis of cardiac etiologyusing simple tests in witnessed cardiac etiology out-of-hospital cardiac arrest cases,which is emphasized in the Utstein Style.Method: The subjects were 165 witnessed cardiac etiology out-of-hospital cardiacarrest cases, which were transported to Kobe University Hospital during the five-yearperiod between January 1, 2005 and December 31, 2009. A comparative study wasconducted into whether there were any significant differences in the initialelectrocardiogram (ECG) and the various early diagnostic markers of acute myocardialinfarction between the group who were finally diagnosed as being of cardiac etiologyand the group who were finally diagnosed as being of non-cardiac etiology.Results: Of the 165 witnessed cardiac etiological cases, 69 cases were finallyre-classified as non-cardiac etiological cases on the basis of scrutiny after admission orpostmortem findings by the Medical Examiner. Ventricular fibrillation shown in theinitial ECG and Qualitative cardiac troponin T test positive were significantly higher inthe final diagnosis cardiac group than in the final diagnosis non-cardiac group.Ventricular fibrillation and troponin T positive can be seen as significant indicators indetermining whether a case was cardiac or non-cardiac, and the model χ2 test result ofp < 0.01 in the multiple logistic regression analysis was significant, and the determiningpredictive value was 65.4%.Conclusion: The indicators which should be noted in simple tests to improve theprecision of discrimination of cardiac etiology in out-of-hospital cardiac arrests areventricular fibrillation in the initial ECG and the qualitative test of cardiac troponin T.

• 神戸大学の論文
• 2011-00-00

著者

• Nakao Hiroyuki

  Division Of Biomaterials Science Graduate School Of Dentistry Osaka University

• Nagasaki Yasushi

  Medical Examiner's Office Of Hyogo Prefecture C/o Kobe University Graduate School Of Medicine

• Yoshida Takeshi

  Division of Disaster and Emergency Medicine, Kobe University Graduate School of Medicine

• Kawashima Takahisa

  Division of Disaster and Emergency Medicine, Kobe University Graduate School of Medicine

• Itagaki Yusuke

  Division of Disaster and Emergency Medicine, Kobe University Graduate School of Medicine

• Kato Takayuki

  Division of Disaster and Emergency Medicine, Kobe University Graduate School of Medicine

• Ishii Noboru

  Division of Disaster and Emergency Medicine, Kobe University Graduate School of Medicine

• Imamura Akira

  Kobe City Fire Department

• Nagasaki Yasushi

  Medical Examiner's Office of Hyogo Prefecture

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• Actual Situation Regarding Cardiac Etiology Determined by Clinical Diagnosis of and Medical Examiner's Postmortem Findings on Witnessed Out-of-hospital Cardiac Arrest Cases

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