[EngO2-3] Geographical differences on national meeting effect in patients with out-of-hospital cardiac arrests: A report from the JCS-ReSS study
【
ライブ配信】
Background: The “national meeting effect” was not found in outcomes among patients hospitalized with out-of-hospital cardiac arrests (OHCA) between national meeting days and non-meeting days in Japan. We hypothesized that that the outcomes would be better after meeting days because of the positive impact of the academic meeting for high performance and the outcomes would differ given geographical differences. The aim of this study was to examine the differences in outcomes after OHCA among patients admitted during, before, and after meeting days according to the geographical regions and the location where the meeting was held, which had not been accounted for in the previous study.
Methods: Using a database of a nationwide, prospective, population-based, observational study in Japan, we analyzed adult OHCA patients with resuscitation attempts between 2011 and 2015. A 1-month favorable neurological outcome was compared among the patients admitted during dates of three national meetings (Japanese Society of Intensive Care Medicine, Japanese Circulation Society, and Japanese Association for Acute Medicine), those admitted on identical days during one week before, and those one week after the meeting dates. Additional analysis was conducted dividing into East and West Japan, and whether the meeting was held in the Tokyo metropolitan area or others. We developed a multiple logistic regression model after adjusting for confounding factors, with after meeting days group as the reference.
Results: A total of 40849 patients were included with 14490, 13518, and 12841 patients of during, before, and after meeting days, respectively. A rate of favorable neurological outcome during, before, and after meeting days was 1.7, 1.6, 1.8%, respectively. After adjusting covariates, there were no differences in favorable neurological outcomes among the three groups. Regarding East Japan, a rate of favorable neurological outcome during, before, and after meeting days was 1.5, 1.3, 1.8%, respectively. An adjusted rate of favorable neurological outcome before meeting days was lower than after meeting days regardless of the meeting location (odds ratio 0.72, 95% CI 0.56-0.93, P=0.011). As for West Japan, a rate of favorable neurological outcome during, before, and after meeting days was 2.1, 2.0, 1.8%, respectively, which were not different after adjustment of confounding variables.
Conclusion: The “national meeting effect” in patients with OHCA may exist in East Japan, suggesting potentially positive or negative impact of national meetings on daily clinical practice. Further investigations are required to validate our results.
Methods: Using a database of a nationwide, prospective, population-based, observational study in Japan, we analyzed adult OHCA patients with resuscitation attempts between 2011 and 2015. A 1-month favorable neurological outcome was compared among the patients admitted during dates of three national meetings (Japanese Society of Intensive Care Medicine, Japanese Circulation Society, and Japanese Association for Acute Medicine), those admitted on identical days during one week before, and those one week after the meeting dates. Additional analysis was conducted dividing into East and West Japan, and whether the meeting was held in the Tokyo metropolitan area or others. We developed a multiple logistic regression model after adjusting for confounding factors, with after meeting days group as the reference.
Results: A total of 40849 patients were included with 14490, 13518, and 12841 patients of during, before, and after meeting days, respectively. A rate of favorable neurological outcome during, before, and after meeting days was 1.7, 1.6, 1.8%, respectively. After adjusting covariates, there were no differences in favorable neurological outcomes among the three groups. Regarding East Japan, a rate of favorable neurological outcome during, before, and after meeting days was 1.5, 1.3, 1.8%, respectively. An adjusted rate of favorable neurological outcome before meeting days was lower than after meeting days regardless of the meeting location (odds ratio 0.72, 95% CI 0.56-0.93, P=0.011). As for West Japan, a rate of favorable neurological outcome during, before, and after meeting days was 2.1, 2.0, 1.8%, respectively, which were not different after adjustment of confounding variables.
Conclusion: The “national meeting effect” in patients with OHCA may exist in East Japan, suggesting potentially positive or negative impact of national meetings on daily clinical practice. Further investigations are required to validate our results.