Mid-term (30- to 90-day) neurological changes in out-of-hospital cardiac arrest survivors receiving extracorporeal cardiopulmonary resuscitation: a nationwide retrospective study (the JAAM-OHCA registry)

IF 2.4 Q3 CRITICAL CARE MEDICINE
Takashi Hongo , Tetsuya Yumoto , Tsuyoshi Nojima , Takafumi Obara , Yoshiyuki Ueda , Takashi Yorifuji , Atsunori Nakao , Hiromichi Naito
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Abstract

Background

Few studies have examined mid-term neurological changes in out-of-hospital cardiac arrest (OHCA) patients after receiving extracorporeal cardiopulmonary resuscitation (ECPR). This study aimed to evaluate neurological improvements between 30 and 90 days in OHCA patients treated with ECPR or conventional cardiopulmonary resuscitation (CCPR) using a large nationwide cohort.

Methods

This retrospective multicenter study used data from a Japanese nationwide OHCA registry. Participants were categorized into ECPR and CCPR groups based on the initial resuscitation method. Neurological changes between 30 and 90 days were assessed using Cerebral Performance Category (CPC) scores. The primary outcome was neurological improvement, defined as an improvement in CPC score during this period.

Results

A total of 4467 OHCA survivors at 30 days were included, 669 in the ECPR group and 3798 in the CCPR group. At 30 days, favorable neurological outcomes were observed in 318 ECPR patients (47.5 %) and 2103 CCPR patients (55.4 %). Neurological improvement between 30 and 90 days was more frequent in the ECPR group (83 [12.4 %] vs. 258 [6.7 %]). There was no significant difference in 90-day mortality between the two groups (82 [12.2 %] vs. 519 [13.6 %]). ECPR was independently associated with 30- to 90-day neurological improvement (adjusted odds ratio (OR) 2.01; 95 % confidence interval (CI), 1.38–2.93) but was not associated with 90-day mortality (adjusted OR 1.11; 95 % CI, 0.77–1.59).

Conclusion

ECPR was associated with a greater likelihood of neurological improvement between 30 and 90 days. By 90 days, mortality was nearly the same in both groups.
院外心脏骤停幸存者接受体外心肺复苏后中期(30- 90天)神经学变化:一项全国性回顾性研究(jama - ohca登记)
很少有研究调查院外心脏骤停(OHCA)患者接受体外心肺复苏(ECPR)后的中期神经学变化。本研究旨在评估接受ECPR或传统心肺复苏(CCPR)治疗的OHCA患者在30至90天内的神经系统改善情况。方法本回顾性多中心研究采用日本全国OHCA登记处的数据。根据初始复苏方式分为ECPR组和CCPR组。使用脑功能分类(CPC)评分评估30至90天的神经学变化。主要结果是神经系统改善,定义为在此期间CPC评分的改善。结果共纳入30d OHCA存活者4467例,其中ECPR组669例,CCPR组3798例。在30天,318例ECPR患者(47.5%)和2103例CCPR患者(55.4%)的神经系统预后良好。ECPR组在30 - 90天的神经系统改善更为频繁(83例[12.4%]对258例[6.7%])。两组90天死亡率无显著差异(82例[12.2%]对519例[13.6%])。ECPR与30- 90天神经系统改善独立相关(校正优势比(OR) 2.01;95%可信区间(CI), 1.38-2.93),但与90天死亡率无关(调整OR为1.11;95% CI, 0.77-1.59)。结论ecpr与30 ~ 90天神经系统改善的可能性较大相关。到90天,两组的死亡率几乎相同。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Resuscitation plus
Resuscitation plus Critical Care and Intensive Care Medicine, Emergency Medicine
CiteScore
3.00
自引率
0.00%
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审稿时长
52 days
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