[EngO2-4] Are school hours associated with better outcomes of out-of-hospital cardiac arrest in school children?
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ライブ配信】
Aims: To investigate whether school hours are associated with better outcomes of school children with out-of-hospital cardiac arrest (OHCA).
Methods: From the 2005–2014 nation-wide databases, we extracted the data for 1,660 bystander-witnessed OHCA cases of school children with ages of 6–17 years, managed without any involvement of physician. Univariate analyses followed by propensity-matching procedures and stepwise multivariate logistic regression analyses including major factors known to be associated with outcomes were applied. School hours are defined as 8:00 am to 6:00 pm. School days in each prefecture were determined by excluding weekends, national and school holidays.
Results: Neurologically favorable 1-month survival during school hours was better than that during non-school hours only in school days: 18.5% (76/412) vs 10.5% (51/486) in school days (Unadjusted OR;95% CI, 1.93;1.32–2.83), 10.9% (43/395) vs 9.0% (33/367) in non-school days (1.24;0.77–1.99). However, interaction between school days and school hours in the survival was not significant. Cases with OHCA during school hours in school days more frequently received bystander CPR and public access defibrillation (PAD) and had shockable initial rhythm and presumed cardiac etiology. However, the survival (P for trend = 0.21) was not improved change during the study period despite increased proportion of AED installation at school and augmented incidences of PAD. Furthermore, the rate of survival did not significantly differ between school hours in school days and others after propensity-matching: 16.2% (52/321) vs 15.6% (50/321), P = 0.83. Stepwise multivariate logistic regression analysis after propensity-matching disclosed that shockable initial rhythm (adjusted OR; 95% CI, 5.53; 2.10–16.4), PAD (4.89; 2.34–10.5), endogenous causes (3.56; 1.42–9.03), and shorter response time interval (1.12;1.03–1.23 per 1 min) and witness-to-first CPR interval (1.06; 1.02–1.10) were major factors associated with higher chances of survival.
Conclusions: Early bystander- and EMS-performed basic life support based on a proper preparedness is predominantly associated with better outcomes of OHCA in school children.
Methods: From the 2005–2014 nation-wide databases, we extracted the data for 1,660 bystander-witnessed OHCA cases of school children with ages of 6–17 years, managed without any involvement of physician. Univariate analyses followed by propensity-matching procedures and stepwise multivariate logistic regression analyses including major factors known to be associated with outcomes were applied. School hours are defined as 8:00 am to 6:00 pm. School days in each prefecture were determined by excluding weekends, national and school holidays.
Results: Neurologically favorable 1-month survival during school hours was better than that during non-school hours only in school days: 18.5% (76/412) vs 10.5% (51/486) in school days (Unadjusted OR;95% CI, 1.93;1.32–2.83), 10.9% (43/395) vs 9.0% (33/367) in non-school days (1.24;0.77–1.99). However, interaction between school days and school hours in the survival was not significant. Cases with OHCA during school hours in school days more frequently received bystander CPR and public access defibrillation (PAD) and had shockable initial rhythm and presumed cardiac etiology. However, the survival (P for trend = 0.21) was not improved change during the study period despite increased proportion of AED installation at school and augmented incidences of PAD. Furthermore, the rate of survival did not significantly differ between school hours in school days and others after propensity-matching: 16.2% (52/321) vs 15.6% (50/321), P = 0.83. Stepwise multivariate logistic regression analysis after propensity-matching disclosed that shockable initial rhythm (adjusted OR; 95% CI, 5.53; 2.10–16.4), PAD (4.89; 2.34–10.5), endogenous causes (3.56; 1.42–9.03), and shorter response time interval (1.12;1.03–1.23 per 1 min) and witness-to-first CPR interval (1.06; 1.02–1.10) were major factors associated with higher chances of survival.
Conclusions: Early bystander- and EMS-performed basic life support based on a proper preparedness is predominantly associated with better outcomes of OHCA in school children.