Physician Presence in an Ambulance Car Is Associated with Increased Survival in Out-of-Hospital Cardiac Arrest: A Prospective Cohort AnalysisReport as inadecuate




Physician Presence in an Ambulance Car Is Associated with Increased Survival in Out-of-Hospital Cardiac Arrest: A Prospective Cohort Analysis - Download this document for free, or read online. Document in PDF available to download.

The presence of a physician seems to be beneficial for pre-hospital cardiopulmonary resuscitation CPR of patients with out-of-hospital cardiac arrest. However, the effectiveness of a physician-s presence during CPR before hospital arrival has not been established. We conducted a prospective, non-randomized, observational study using national data from out-of-hospital cardiac arrests between 2005 and 2010 in Japan. We performed a propensity analysis and examined the association between a physician-s presence during an ambulance car ride and short- and long-term survival from out-of-hospital cardiac arrest. Specifically, a full non-parsimonious logistic regression model was fitted with the physician presence in the ambulance as the dependent variable; the independent variables included all study variables except for endpoint variables plus dummy variables for the 47 prefectures in Japan i.e., 46 variables. In total, 619,928 out-of-hospital cardiac arrest cases that met the inclusion criteria were analyzed. Among propensity-matched patients, a positive association was observed between a physician-s presence during an ambulance car ride and return of spontaneous circulation ROSC before hospital arrival, 1-month survival, and 1-month survival with minimal neurological or physical impairment ROSC: OR = 1.84, 95% CI 1.63–2.07, p = 0.00 in adjusted for propensity and all covariates; 1-month survival: OR = 1.29, 95% CI 1.04–1.61, p = 0.02 in adjusted for propensity and all covariates; cerebral performance category 1 or 2: OR = 1.54, 95% CI 1.03–2.29, p = 0.04 in adjusted for propensity and all covariates; and overall performance category 1 or 2: OR = 1.50, 95% CI 1.01–2.24, p = 0.05 in adjusted for propensity and all covariates. A prospective observational study using national data from out-of-hospital cardiac arrests shows that a physician-s presence during an ambulance car ride was independently associated with increased short- and long-term survival.



Author: Akihito Hagihara , Manabu Hasegawa, Takeru Abe, Takashi Nagata, Yoshihiro Nabeshima

Source: http://plos.srce.hr/



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