Regional Variation in Survival Following Pediatric Out-of-Hospital Cardiac Arrest
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概要
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Background: Although regional variation in outcome after adult out-of-hospital cardiac arrest (OHCA) is known, no clinical studies have assessed this in pediatric OHCA. Methods and Results: This nationwide, prospective, population-based observation of the whole of Japan included consecutive OHCA patients with resuscitation attempt from January 2005 through December 2009. Primary outcome was 1-month survival with neurologically favorable outcome. Japan was divided into the following 7 regions as the largest administrative units: Hokkaido-Tohoku, Kanto, Tokai-Hokuriku, Kinki, Chugoku, Shikoku, and Kyushu-Okinawa. The outcome of pediatric OHCA was then compared between the regions. Multiple logistic regression analysis was used to adjust for other factors that were considered to influence the relationship between region and outcome. A total of 8,240 pediatric OHCA patients were registered during the study period. One-month survival with neurologically favorable outcome significantly differed by region: 2.5% (24/967) in Hokkaido-Tohoku (adjusted odds ratio [AOR], 1.65; 95% confidence interval [CI]: 0.94–2.90), 2.9% (47/1614) in Tokai-Hokuriku (AOR, 2.06; 95% CI: 1.28–3.31), 2.1% (26/1239) in Kinki (AOR, 1.45; 95% CI: 0.84–2.51), 3.4% (16/465) in Chugoku (AOR, 3.11; 95% CI: 1.62–6.00), 1.5% (4/259) in Shikoku (AOR, 0.79; 95% CI: 0.26–2.43), and 2.8% (27/974) in Kyushu-Okinawa (AOR, 2.15; 95% CI: 1.24–3.74) referred to Kanto (1.4%, 37/2722). Conclusions: According to Japanese nationwide OHCA registry data there are significant regional variations in the outcome of pediatric OHCA.
著者
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KAWAMURA Takashi
Kyoto University Center for Student Health
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Nitta Masahiko
Department Of Anesthesiology Tokai University School Of Medicine
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Okamoto Yoshio
Department Of Applied Chemistry Faculty Of Engineering Nagoya University
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Morishima Tsuneo
Department Of Health Science Nagoya University
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Hiraide Atsushi
Department Of Acute Medicine Kinki University Faculty Of Medicine
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Iwami Taku
Kyoto University Health Service
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Kitamura Tetsuhisa
Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University
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Okamoto Yoshio
Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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