Study regarding the effects of biomarkers and advanced intensive cares on the survival among patients with out-of-hospital cardiac arrest

• Project/Area Number: 16K09034
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Epidemiology and preventive medicine
• Research Institution: Osaka University
• Principal Investigator: Kitamura Tetsuhisa 大阪大学, 医学系研究科, 助教 (30639810)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥3,770,000 (Direct Cost: ¥2,900,000、Indirect Cost: ¥870,000); Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2017: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2016: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
• Keywords: 救急医学 / 蘇生科学 / 院外心停止 / 臨床疫学 / 予後 / バイオマーカー / 救急 / 蘇生

Outline of Final Research Achievements

This study aimed to assess the effects of biomarkers and advanced intensive cares on the survival among patients with OHCA, and has been collected 8,721 OHCA patients from critical care medical centers in Osaka Prefecture between 2012 and 2016. In 1,516 adult patients with OHCA of cardiac origin who achieved return of spontaneous circulation (ROSC), the proportion of favorable neurological outcome (defined as cerebral performance category scale 1 or 2) decreased as the serum potassium level increased in the multivariable analysis (adjusted p for trend<0.001). In 2,894 adult patients with OHCA of non-traumatic origin who achieved ROSC, the proportions of 1-month survival with favorable neurological outcome were almost consistent, and there were no significant differences between the intra-aortic balloon pumping (IABP) use group and the non-IABP use group (adjusted odds ratio, 0.97; 95% confidence interval, 0.55-1.74) by using the propensity-score matched analysis.

Academic Significance and Societal Importance of the Research Achievements

院外心停止患者に対するバイオマーカーと高度集中治療に関する先行研究では、ガイドライン上で確立されるようなエビデンスは十分でなかった。本多施設共同前向きにおいて、高カリウム血症と院外心停止患者の予後との関係を明らかにした本解析は、院外心停止後転帰改善のための予後予測をつながり、病院搬送後の高度集中治療実施の可否などの基準を提案することができる。また、病院搬送後にIABPという循環補助デバイス導入が院外心停止患者の予後改善と明らかな関係は認められなかったことは、院外心停止患者への循環補助デバイスあり方に一石を投じ、心肺蘇生ガイドラインに貢献できるエビデンスと思われる。

Research Products

• [Journal Article] Sex difference in receiving layperson cardiopulmonary resuscitation in paediatric out-of-hospital cardiac arrest: a nationwide cohort study in Japan (2019)
  • Author(s): Okubo M,* Matsuyama T,* Gibo K, Komukai S, Izawa J, Kiyohara K, Nishiyama C, Kiguchi T, Callaway CW, Iwami T, Kitamura T
  • Journal Title: Journal of the American Heart Association Volume: 8(1) Issue: 1
  • DOI: 10.1161/jaha.118.010324
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Out-of-hospital cardiac arrest at home: a nationwide observation in Japan (2019)
  • Author(s): Kiyohara K, Nishiyama C, Matsuyama T, Sado J, Kitamura T, Shimamoto T, Kobayashi D, Kiguchi T, Okabayashi S, Kawamura T, Iwami T
  • Journal Title: The American Journal of Cardiology Volume: 123(7) Issue: 7 Pages: 1060-1068
  • DOI: 10.1016/j.amjcard.2018.12.038
  • Peer Reviewed
• [Journal Article] Pre-hospital advanced airway management for adult patients with out-of-hospital cardiac arrest: a nationwide cohort study (2019)
  • Author(s): Izawa J, Komukai S, Gibo K, Okubo M, Kiyohara K, Nishiyama C, Kiguchi T, Matsuyama T, Kawamura T, Iwami T, Callaway CW, Kitamura T
  • Journal Title: The BMJ Volume: 364 Pages: l430-l430
  • DOI: 10.1136/bmj.l430
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Timing of advanced airway management by emergency medical services personnel following out-of-hospital cardiac arrest: a population-based cohort study (2018)
  • Author(s): Izawa J, Iwami T, Gibo K, Okubo M, Kajino K, Kiyohara K, Nishiyama C, Nishiuchi T, Hayashi Y, Kiguchi T, Kobayashi D, Komukai S, Kawamura T, Callaway CW, Kitamura T
  • Journal Title: Resuscitation Volume: 128(7) Pages: 16-23
  • DOI: 10.1016/j.resuscitation.2018.04.024
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] The profile of Japanese Association for Acute Medicine out-of-hospital cardiac arrest registry in 2014-2015 (2018)
  • Author(s): Kitamura T, Iwami T, Atsumi T, Endo T, Kanna T, Kuroda Y, Sakurai A, Tasaki O, Tahara Y, Tsuruta R, Tomio J, Nakata K, Nachi S, Hase M, Hayakawa M, Hiruma T, Hiasa K, Muguruma T, Yano T, Shimazu Y, Morimura N
  • Journal Title: Acute Medicine & Surgery Volume: 5(3) Issue: 3 Pages: 249-258
  • DOI: 10.1002/ams2.340
  • Peer Reviewed / Open Access
• [Journal Article] Ten-Year Trends of Public-Access Defibrillation in Japanese School-Aged Patients Having Neurologically Favorable Survival After Out-of-Hospital Cardiac Arrest (2018)
  • Author(s): Kiyohara Kosuke、Nitta Masahiko、Sato Yasuto、Kojimahara Noriko、Yamaguchi Naohito、Iwami Taku、Kitamura Tetsuhisa
  • Journal Title: The American Journal of Cardiology Volume: 122 Issue: 5 Pages: 890-897
  • DOI: 10.1016/j.amjcard.2018.05.021
  • Peer Reviewed / Open Access
• [Journal Article] Assessment of the 11-year nationwide trend of elderly patients with out-of-hospital cardiac arrest cases in Japan (2005-2015) (2018)
  • Author(s): Matsuyama T, Kitamura T, Kiyohara K, Kiguchi T, Kobayashi D, Nishiyama C, Iwami T, Ota B
  • Journal Title: Resuscitation Volume: 131(10) Pages: 83-90
  • DOI: 10.1016/j.resuscitation.2018.08.011
  • Peer Reviewed
• [Journal Article] The effect of different target temperatures in targeted temperature management on neurologically favorable outcome after out-of-hospital cardiac arrest: A nationwide multicenter observational study in Japan (the JAAM-OHCA registry) (2018)
  • Author(s): Irisawa Taro、Matsuyama Tasuku、Iwami Taku、Yamada Tomoki、Hayakawa Koichi、Yoshiya Kazuhisa、Noguchi Kazuo、Nishimura Tetsuro、Uejima Toshifumi、Yagi Yoshiki、Kiguchi Takeyuki、Kishimoto Masafumi、Matsuura Makoto、Hayashi Yasuyuki、Sogabe Taku、Morooka Takaya、Kitamura Tetsuhisa、Shimazu Takeshi
  • Journal Title: Resuscitation Volume: 133 Pages: 82-87
  • DOI: 10.1016/j.resuscitation.2018.10.004
  • Peer Reviewed / Open Access
• [Journal Article] Characteristics and outcomes of out-of-hospital cardiac arrest occurring while in a motor vehicle (2018)
  • Author(s): Sado J, Kiyohara K, Hayashida S, Matsuyama T, Katayama Y, Hirose T, Kiguchi T, Nishiyama C, Iwami T, Kitamura Y, Sobue T, Kitamura T
  • Journal Title: The American Journal of Cardiology Volume: E-pub ahead of print Issue: 11 Pages: 1-6
  • DOI: 10.1016/j.amjcard.2018.02.018
  • Peer Reviewed
• [Journal Article] Chest compression-only versus conventional cardiopulmonary resuscitation for bystander-witnessed out-of-hospital cardiac arrest of medical origin: a propensity score-matched cohort from 143,500 patients (2018)
  • Author(s): Kitamura T, Kiyohara K, Nishiyama C, Kiguchi T, Kobayashi D, Kawamura T, Taku Iwami
  • Journal Title: Resuscitation Volume: 126(5) Pages: 29-35
  • DOI: 10.1016/j.resuscitation.2018.02.017
  • Peer Reviewed
• [Journal Article] Three-Year Follow-up After the Great East Japan Earthquake in the Incidence of Out-of-Hospital Cardiac Arrest With Cardiac Origin (2018)
  • Author(s): Sado J, Kiyohara K, Iwami T, Kitamura Y, Ando E, Ohira T, Sobue T, Kitamura T
  • Journal Title: Circulation Journal Volume: 82 Issue: 3 Pages: 919-922
  • DOI: 10.1253/circj.CJ-17-1003
  • NAID: 130006394525
  • ISSN: 1346-9843, 1347-4820
  • Peer Reviewed / Open Access
• [Journal Article] Prognostic impact of serum albumin concentration for neurologically favorable outcome in patients treated with target temperature management after out-of-hospital cardiac arrest: a multicenter prospective study (2018)
  • Author(s): Matsuyama T, Iwami T, Yamada T, Hayakawa K, Yoshiya K, Irisawa T, Abe Y, Nishimura T, Uejima T, Ohishi Y, Kiguchi T, Kishi M, Kishimoto M, Nakao S, Hayashi Y, Sogabe T, Morooka T, Izawa J, Shimamoto T, Hatakeyama T, Fujii T, Sado J, Kawamura T, Shimazu T, Kitamura T
  • Journal Title: Therapeutic Hypothermia and Temperature Management Volume: E-pub ahead of print Issue: 3 Pages: 1-6
  • DOI: 10.1089/ther.2017.0053
  • Peer Reviewed / Open Access
• [Journal Article] Regional variation in functional outcome after out-of-hospital cardiac arrest across 47 Prefectures in Japan (2018)
  • Author(s): Okubo M, Gibo K, Wallace DJ, Komukai S, Izawa J, Kiyohara K, Callaway CW, Iwami Y, Kitamura T
  • Journal Title: Resuscitation Volume: 124(3) Pages: 21-28
  • DOI: 10.1016/j.resuscitation.2017.12.030
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Epidemiology of Out-of-Hospital Cardiac Arrest Due to Suffocation Focusing on Suffocation Due to Japanese Rice Cake: A Population-Based Observational Study From the Utstein Osaka Project (2018)
  • Author(s): Kiyohara K, Sakai T, Nishiyama C, Nishiuchi T, Hayashi Y, Iwami T, Kitamura T
  • Journal Title: Journal of Epidemiology Volume: 28 Issue: 2 Pages: 67-74
  • DOI: 10.2188/jea.JE20160179
  • NAID: 130006337731
  • ISSN: 0917-5040, 1349-9092
  • Peer Reviewed / Open Access
• [Journal Article] Effect of serum albumin concentration on favorable neurological outcome after out-of-hospital cardiac arrest (From the CRITICAL Study in Osaka, Japan) (2018)
  • Author(s): Matsuyama T, Iwami T, Yamada T, Hayakawa K, Yoshiya K, Irisawa T, Abe Y, Nishimura T, Uejima T, Ohishi Y, Kiguchi T, Kishi M, Kishimoto M, Nakao S, Hayashi Y, Sogabe T, Morooka T, Izawa J, Shimamoto T, Hatakeyama T, Fujii T, Sado J, Shimazu T, Kawamura T, Kitamura T
  • Journal Title: The American Journal of Cardiology Volume: 121(2) Issue: 2 Pages: 156-161
  • DOI: 10.1016/j.amjcard.2017.10.005
  • Peer Reviewed / Open Access
• [Journal Article] Prehospital intravenous access and adrenaline administration for survival from out-of-hospital cardiac arrest: propensity score matched analyses from a population-based cohort study in Osaka, Japan (2017)
  • Author(s): Fujii T, Kitamura T, Kajino K, Kiyohara K, Nishiyama C, Nishiuchi T, Hayashi Y, Kawamura T, Iwami T
  • Journal Title: BMJ Open Volume: 7(12) Issue: 12 Pages: e015055-e015055
  • DOI: 10.1136/bmjopen-2016-015055
  • Peer Reviewed / Open Access
• [Journal Article] Improving outcomes of witnessed out-of-hospital cardiac arrest after implementation of ILCOR 2010 consensus: a nationwide prospective observational population-based study (2017)
  • Author(s): Kaneko H, Hara M Mizutani K, Yoshiyama M, Yokoi K, Kabata D, Shintani A, Kitamura T
  • Journal Title: Journal of the American Heart Association Volume: 6(8) Issue: 8
  • DOI: 10.1161/jaha.116.004959
  • Peer Reviewed / Open Access
• [Journal Article] Exercise-related out-of-hospital cardiac arrest among the general population in the era of public-access defibrillation: a population-based observation in Japan (2017)
  • Author(s): Kiyohara K, Nishiyama C, Kiguchi T, Nishiuchi T, Hayashi Y, Iwami T, Kitamura T
  • Journal Title: Journal of the American Heart Association Volume: 6 Issue: 6
  • DOI: 10.1161/jaha.117.005786
  • NAID: 120006955494
  • Peer Reviewed / Open Access
• [Journal Article] Out-of-hospital cardiac arrests during exercise among urban inhabitants in Japan: insights from a population-based registry of Osaka City (2017)
  • Author(s): Kiyohara K, Sado J, Matsuyama T, Nishiyama C, Kobayashi D, Kiguchi T, Hayashida S, Kitamura Y, Nakata K, Sobue T, Iwami T, Kitamura T
  • Journal Title: Resuscitation Volume: 117(8) Pages: 14-17
  • DOI: 10.1016/j.resuscitation.2017.05.025
  • Peer Reviewed
• [Journal Article] Nationwide and regional trends in survival from out-of-hospital cardiac arrest in Japan: a 10-year observation from 2005 to 2014 (2017)
  • Author(s): Okubo M, Kiyohara K, Iwami T, Callaway CW, Kitamura T
  • Journal Title: Resuscitation Volume: 115(6) Pages: 120-128
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Impact of cardiopulmonary resuscitation duration on neurologically favourable outcome after out-of-hospital cardiac arrest: a population-based study in Japan (2017)
  • Author(s): Matsuyama T, Kitamura T, Kiyohara K, Nishiyama C, Nishiuchi T, Hayashi Y, Kawamura T, Ohta B, Iwami T
  • Journal Title: Resuscitation Volume: 113 Pages: 1-7
  • DOI: 10.1016/j.resuscitation.2017.01.005
  • Peer Reviewed
• [Journal Article] Hospital characteristics and favorable neurological outcome among patients with out-of-hospital cardiac arrest in Osaka, Japan (2017)
  • Author(s): Matsuyama T, Kiyohara K, Kitamura T, Nishiyama C, Nishiuchi T, Hayashi Y, Kawamura T, Ohta B, Iwami T
  • Journal Title: Resuscitation Volume: 110 Pages: 146-153
  • DOI: 10.1016/j.resuscitation.2016.11.009
  • Peer Reviewed
• [Journal Article] Public-access defibrillation and out-of-hospital cardiac arrest in Japan (2016)
  • Author(s): Kitamura T,* Kiyohara K,* Sakai T, Matsuyama T, Hatakeyama T, Shimamoto T, Izawa J, Fujii T, Nishiyama C, Kawamura T, Iwami T
  • Journal Title: The New England Journal of Medicine 2016 Volume: 375 Issue: 17 Pages: 1649-1659
  • DOI: 10.1056/nejmsa1600011
  • NAID: 120006955490
  • Peer Reviewed
• [Journal Article] High-rise buildings and neurologically favorable outcome after out-of-hospital cardiac arrest (2016)
  • Author(s): Kobayashi D, Kitamura T, Kiyohara K, Nishiyama C, Hayashida S, Fujii T, Izawa J, Shimamoto T, Matsuyama T, Hatakeyama T, Katayama Y, Kiguchi T, Kawamura T, Iwami T
  • Journal Title: International Journal of Cardiology Volume: 224 Pages: 178-182
  • DOI: 10.1016/j.ijcard.2016.09.047
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Outcomes differ by first documented rhythm after witnessed out-of-hospital cardiac arrest in children; an observational study with prospective nationwide population-based cohort database in Japan (2016)
  • Author(s): Hara M, Hayashi K, Kitamura T
  • Journal Title: European Heart Journal - Quality of Care and Clinical Outcomes Volume: 3 Issue: 1 Pages: 83-92
  • DOI: 10.1093/ehjqcco/qcw040
  • Peer Reviewed
• [Journal Article] Public-access AED pad application and outcomes for out-of-hospital cardiac arrests in Osaka, Japan (2016)
  • Author(s): Kiyohara K, Kitamura T, Sakai T, Nishiyama C, Nishiuchi T, Hayashi Y, Sakamoto T, Marukawa S, Iwami T
  • Journal Title: Resuscitation Volume: 106 Pages: 70-75
  • DOI: 10.1016/j.resuscitation.2016.06.025
  • Peer Reviewed
• [Journal Article] Characteristics and Outcomes of Bath-Related Out-of-Hospital Cardiac Arrest in Japan (2016)
  • Author(s): Kiyohara K, Nishiyama C, Hayashida S, Matsuyama T, Hatakeyama T, Shimamoto T, Izawa J, Fujii T, Katayama Y, Iwami T, Kitamura T
  • Journal Title: Circulation Journal Volume: 80 Issue: 7 Pages: 1564-1570
  • DOI: 10.1253/circj.CJ-16-0241
  • NAID: 130005158918
  • ISSN: 1346-9843, 1347-4820
  • Peer Reviewed
• [Presentation] 第1回JAAM多施設共同院外心停止レジストリ成果報告会: 成果報告1（プロファイル論文） (2018)
  • Author(s): 北村哲久
  • Organizer: 第46回日本救急医学会総会・学術集会
• [Presentation] Association of Serum Potassium Levels With Favorable Neurological OutcomeAfter Out-of-Hospital Cardiac Arrest: The CRITICAL Study in Osaka, Japan (2018)
  • Author(s): Shida H, Matsuyama M, Kitamura T, Kishimori T, Kiyohara K, Okabayashi S, Kawamura T, Iwami T
  • Organizer: 2018 American Heart Association Scientific Session, Resuscitation Science Symposium
  • Int'l Joint Research
• [Presentation] 心血管疾患の臨床疫学研究の課題と展開～臨床から地域へ、地域から臨床へ～循環器臨床疫学研究における疫学者の関わり (2018)
  • Author(s): 北村哲久
  • Organizer: 第82回日本循環器学会学術集会
  • Invited
• [Presentation] 日本からのThe New England Journal of Medicineへの挑戦～リアルワールドエビデンスの重要性～ (2017)
  • Author(s): 北村哲久
  • Organizer: 第45回日本救急医学会総会
  • Invited
• [Presentation] Arterial hyperoxia exposure time and survival among resuscitated patients with out-of-hospital cardiac arrest, The Critical Study in Osaka, Japan (2017)
  • Author(s): Kiguchi T, Kitamura T, Kobayashi D, Nishiyama C, Fujimi S, Kawamura T, Iwami T
  • Organizer: Resuscitation Symposium, American Heart Association Scientific Sessions 2017
  • Int'l Joint Research
• [Presentation] The relationship between the targeted temperature of TTM and neurological outcome, the CRITICAL Study in Osaka, Japan (2017)
  • Author(s): Irisawa T, Matsuyama T, Kiguchi T, Kitamura T, Yoshiya K, Iwami T, Kawamura T, Shimazu T
  • Organizer: Resuscitation Symposium, American Heart Association Scientific Sessions 2017
  • Int'l Joint Research
• [Presentation] 治療的体温管理療法での導入速度についての検討―多施設研究Critical Study を通じて― (2016)
  • Author(s): 西村哲郎、森岡貴勢、溝端康光、田原良雄、北村哲久、石見 拓
  • Organizer: 第44回日本救急医学会総会
  • Place of Presentation: 東京都港区高輪
  • Year and Date: 2016-11-17
• [Presentation] Survival after Out-of-hospital Cardiac Arrests and Arterial Oxygen Partial Pressure during Cardiopulmonary Resuscitation: The CRITICAL Study in Osaka, Japan (2016)
  • Author(s): Izawa J, Kitamura T, Hayakawa K, Yamada T, Yoshiya K, Abe Y, Uejima T, Ohishi Y, Kiguchi T, Kishi M, Kishimoto M, Nakao S, Nishimura T, Hayashi Y, Morooka T, Sogabe T, Matsuyama T, Shimazu T, Kawamura T, Iwami T
  • Organizer: Resuscitation Symposium, American Heart Association Scientific Sessions
  • Place of Presentation: New Orleans, Louisiana, USA
  • Year and Date: 2016-11-12