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Development of termination-of-resuscitation rules for out-of-hospital cardiac arrest-of-hospital cardiac arrest

Research Project

Project/Area Number 21K10324
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 58010:Medical management and medical sociology-related
Research InstitutionKanazawa University

Principal Investigator

後藤 由和  金沢大学, 医学系, 准教授 (60282167)

Project Period (FY) 2021-04-01 – 2025-03-31
Project Status Granted (Fiscal Year 2023)
Budget Amount *help
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2023: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2022: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2021: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Keywords院外心停止 / 蘇生中止 / 病院前救護 / 医療社会学 / 疫学 / 転帰
Outline of Research at the Start

本研究の目的は、救急隊が蘇生現場で運用可能な「院外心停止に対する発生場所別の蘇生中止基準」を開発・検証し、我が国で初めてとなる救急隊が現場で蘇生を中止する仕組みを提案することである。そのため、消防庁が全国集計している院外心停止データを用いた観察研究を計画した。本研究代表者が先行研究で開発した救急隊員が蘇生現場で判断する「現場蘇生中止基準」に、新たに心停止発生場所の因子を加え、より精度の高い判断基準の開発をめざし、その開発基準の妥当性を検証するものである。

Outline of Annual Research Achievements

本年度は、(A)前年度に開発し論文発表した、院外心停止患者(特に初期心電図が心静止症例)に対応する「来院時蘇生中止基準の改良版(Crit Care 2022;26:137, DOI:10.1186/s13054-022-03999-x)」の追加研究(初期心電図が無脈性電気的活動である院外心停止例にも対応可能な「来院時蘇生中止基準」の開発研究)と(B)小児院外心停止に関する転帰予測モデル(本研究代表者が開発したモデル、Crit Care 2014;18:R133)の外部検証の研究を主な課題とした。(A)の課題においては、消防庁が集積しているウツタイン・データ(N=630,489、2016-2020)を解析・検討した。その結果、無脈性電気的活動初期心電図傷病者が来院した時点で次の項目を満たした場合、すなわち、(1)目撃が無い(2)救急隊の病院前蘇生時間>20分(3)病院到着までに一度も自己心拍再開が無い(4)年齢が80歳以上であることの4項目すべてを満たした場合に、来院後の救命処置を実施することなく、蘇生を中止できるとした。本基準は、心停止後1か月後の死亡予測に対する陽性的中率と特異度が共に99%以上であった。この基準の適応割合は、無脈性電気的活動心停止患者のおよそ8%に該当していた。また、(B)の課題においては、小児院外心停止のウツタイン・データ(N=6,516、2016-2020)を用いて検討した。その結果、4階層分類モデル(Good:生存率80%、Moderately good:生存率50%、Poor:生存率10%、Very poor:生存率5%)は適正性に運用可能であることが示された。以上の研究成果は、第51回日本救急医学会総会・学術集会および欧州心臓病学会2023において発表された(EHJ 2023;44(suppl2):ehad655.1601 and 1573)。

Current Status of Research Progress
Current Status of Research Progress

2: Research has progressed on the whole more than it was originally planned.

Reason

本年度の課題であった2課題を公表することができたので、おおむね順調と判断した。

Strategy for Future Research Activity

本研究課題の英文論文化に至らなかったこと、および心停止発生場所データの解析が不十分であったため、本研究課題を1年延長することとした。

Report

(3 results)
  • 2023 Research-status Report
  • 2022 Research-status Report
  • 2021 Research-status Report
  • Research Products

    (37 results)

All 2024 2023 2022 2021

All Journal Article (14 results) (of which Peer Reviewed: 14 results,  Open Access: 7 results) Presentation (23 results) (of which Int'l Joint Research: 12 results)

  • [Journal Article] Cardiac arrest centre accreditation in Germany: A game-changer for favourable neurological outcomes after cardiac arrest2024

    • Author(s)
      Goto Yoshikazu
    • Journal Title

      Resuscitation

      Volume: 194 Pages: 110090-110090

    • DOI

      10.1016/j.resuscitation.2023.110090

    • Related Report
      2023 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Temporal trends in neurologically intact survival after paediatric out-of-hospital cardiac arrest: a nationwide population-based observational study in Japan2023

    • Author(s)
      Goto Y、Funada A、Goto Y U
    • Journal Title

      European Heart Journal

      Volume: 44 Issue: Supplement_2 Pages: 1601-1601

    • DOI

      10.1093/eurheartj/ehad655.1601

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] Termination-of-resuscitation rule in the emergency department for patients with initial pulseless electrical activity after out-of-hospital cardiac arrest2023

    • Author(s)
      Funada A、Goto Y、Takamura M
    • Journal Title

      European Heart Journal

      Volume: 44 Issue: Supplement_2 Pages: 1573-1573

    • DOI

      10.1093/eurheartj/ehad655.1573

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] No association of CPR duration with long-term survival2023

    • Author(s)
      Yoshikazu Goto
    • Journal Title

      Resuscitation

      Volume: 182 Pages: 109677-109677

    • DOI

      10.1016/j.resuscitation.2022.109677

    • Related Report
      2022 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Termination-of-resuscitation rule in the emergency department for patients with refractory out-of-hospital cardiac arrest: A nationwide, population-based observational study2022

    • Author(s)
      Yoshikazu Goto, Akira Funada, Tetsuo Maeda, Yumiko Goto
    • Journal Title

      Critical Care

      Volume: 26 Issue: 1 Pages: 137-137

    • DOI

      10.1186/s13054-022-03999-x

    • Related Report
      2022 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] External validation of in-field termination-of-resuscitation rules for refractory out-of-hospital cardiac arrests in Japan2022

    • Author(s)
      Yoshikazu Goto, Akira Funada, Tetsuo Maeda, Yumiko Goto
    • Journal Title

      Resuscitation

      Volume: 175(S1) Pages: S30-S30

    • DOI

      10.1016/s0300-9572(22)00414-2

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Revised termination-of-resuscitation rule in the emergency department for patients with refractory out-of-hospital cardiac arrest2022

    • Author(s)
      Yoshikazu Goto, Akira Funada, Tetsuo Maeda, Yumiko Goto
    • Journal Title

      Resuscitation

      Volume: 175(S1) Pages: S30-S30

    • DOI

      10.1016/s0300-9572(22)00413-0

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Abstract 266:Impact of bystander-patient relationship on neurological outcome in witnessed elderly patients with out-of-hospital cardiac arrest according to age: a nationwide population-based observational study2022

    • Author(s)
      Akira Funada, Yoshikazu Goto, Masayuki Takamura
    • Journal Title

      Circulation

      Volume: 146(S1) Issue: Suppl_1

    • DOI

      10.1161/circ.146.suppl_1.266

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Abstract 267:Differences of temporal trends in outcomes after out-of-hospital cardiac arrest between urban and rural regions in Japan: a 4-year observational study from 2016 to 20192022

    • Author(s)
      Akira Funada, Yoshikazu Goto
    • Journal Title

      Circulation

      Volume: 146(S1) Issue: Suppl_1

    • DOI

      10.1161/circ.146.suppl_1.267

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Abstract 296: Relationship between emergency medical service response time and bystander cardiopulmonary resuscitation in children with out-of-hospital cardiac arrest: A nationwide, population-based observational study2022

    • Author(s)
      Akira Funada, Yoshikazu Goto
    • Journal Title

      Circulation

      Volume: 146(S1) Issue: Suppl_1

    • DOI

      10.1161/circ.146.suppl_1.296

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Dispatcher-assisted conventional cardiopulmonary resuscitation and outcomes for paediatric out-of-hospital cardiac arrests2022

    • Author(s)
      Goto Yoshikazu、Funada Akira、Maeda Tetsuo、Goto Yumiko
    • Journal Title

      Resuscitation

      Volume: 172 Pages: 106-114

    • DOI

      10.1016/j.resuscitation.2021.10.003

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Association of dispatcher-assisted cardiopulmonary resuscitation with initial shockable rhythm and survival after out-of-hospital cardiac arrest2021

    • Author(s)
      Goto Yoshikazu、Funada Akira、Maeda Tetsuo、Goto Yumiko
    • Journal Title

      European Journal of Emergency Medicine

      Volume: 29 Issue: 1 Pages: 42-48

    • DOI

      10.1097/mej.0000000000000861

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Association of subsequent treated shockable rhythm with outcomes after paediatric out-of-hospital cardiac arrests: A nationwide, population-based observational study2021

    • Author(s)
      Goto Yoshikazu、Funada Akira、Maeda Tetsuo、Goto Yumiko
    • Journal Title

      Resuscitation Plus

      Volume: 8 Pages: 100181-100181

    • DOI

      10.1016/j.resplu.2021.100181

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Dispatcher instructions for bystander cardiopulmonary resuscitation and neurologically intact survival after bystander-witnessed out-of-hospital cardiac arrests: a nationwide, population-based observational study2021

    • Author(s)
      Goto Yoshikazu、Funada Akira、Maeda Tetsuo、Goto Yumiko
    • Journal Title

      Critical Care

      Volume: 25 Issue: 1 Pages: 408-408

    • DOI

      10.1186/s13054-021-03825-w

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] Temporal trends in neurologically intact survival after paediatric out-of-hospital cardiac arrest: A nationwide population-based observational study in Japan.2023

    • Author(s)
      Goto Yoshikazu、Funada Akira
    • Organizer
      European Society of Cardiology 2023
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research
  • [Presentation] Termination-of-resuscitation rule in the emergency department for patients with initial pulseless electrical activity after out-of-hospital cardiac arrest.2023

    • Author(s)
      Goto Yoshikazu、Funada Akira
    • Organizer
      European Society of Cardiology 2023
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research
  • [Presentation] 小児院外心停止転帰予測モデルの外部検証2023

    • Author(s)
      後藤由和
    • Organizer
      第51回日本救急医学会総会・学術集会
    • Related Report
      2023 Research-status Report
  • [Presentation] 蘇生に反応しない無脈性電気的活動初期心電図の院外心停止に対する来院時蘇生中止基準2023

    • Author(s)
      後藤由和
    • Organizer
      第51回日本救急医学会総会・学術集会
    • Related Report
      2023 Research-status Report
  • [Presentation] バイスタンダーによる胸骨圧迫のみCPRは、何分まで有効か?2023

    • Author(s)
      後藤由和
    • Organizer
      第51回日本救急医学会総会・学術集会
    • Related Report
      2023 Research-status Report
  • [Presentation] 地域差が小児院外心停止の転帰に与える影響2023

    • Author(s)
      後藤由和
    • Organizer
      第51回日本救急医学会総会・学術集会
    • Related Report
      2023 Research-status Report
  • [Presentation] Revised termination-of-resuscitation rule in the emergency department for patients with refractory out-of-hospital cardiac arrest2022

    • Author(s)
      Goto Yoshikazu、Funada Akira、Maeda Tetsuo、Goto Yumiko
    • Organizer
      European resuscitation Council 2022
    • Related Report
      2022 Research-status Report
    • Int'l Joint Research
  • [Presentation] External validation of in-field termination-of-resuscitation rules for refractory out-of-hospital cardiac arrests in Japan2022

    • Author(s)
      Goto Yoshikazu、Funada Akira、Maeda Tetsuo、Goto Yumiko
    • Organizer
      European Resuscitation Council 2022
    • Related Report
      2022 Research-status Report
    • Int'l Joint Research
  • [Presentation] 成人院外心停止に対する現場蘇生中止基準の外部検証2022

    • Author(s)
      後藤由和
    • Organizer
      第25回日本臨床救急医学会総会・学術集会
    • Related Report
      2022 Research-status Report
  • [Presentation] 成人院外心停止に対する来院時蘇生中止基準改良版の開発2022

    • Author(s)
      後藤由和
    • Organizer
      第25回日本臨床救急医学会総会・学術集会
    • Related Report
      2022 Research-status Report
  • [Presentation] 小児院外心停止に対する口頭指導と神経学的転帰の関係2022

    • Author(s)
      後藤由和
    • Organizer
      第25回日本臨床救急医学会総会・学術集会
    • Related Report
      2022 Research-status Report
  • [Presentation] 成人院外心停止の目撃者に対する口頭指導と神経学的転帰の関係2022

    • Author(s)
      後藤由和
    • Organizer
      第25回日本臨床救急医学会総会・学術集会
    • Related Report
      2022 Research-status Report
  • [Presentation] 小児院外心停止後転帰の時間的傾向とその背景:過去15年間のウツタインデータ解析の結果2022

    • Author(s)
      後藤由和
    • Organizer
      第50回日本救急医学会総会・学術集会
    • Related Report
      2022 Research-status Report
  • [Presentation] 院外心停止例に対する来院時蘇生中止基準の精度に対する地域差の影響2022

    • Author(s)
      後藤由和
    • Organizer
      第50回日本救急医学会総会・学術集会
    • Related Report
      2022 Research-status Report
  • [Presentation] 高齢院外心停止例における患者とバイスタンダーの関係が神経学的転帰に与える影響2022

    • Author(s)
      舟田 晃, 後藤 由和
    • Organizer
      第50回日本救急医学会総会・学術集会
    • Related Report
      2022 Research-status Report
  • [Presentation] Impact of bystander-patient relationship on neurological outcome in witnessed elderly patients with out-of-hospital cardiac arrest according to age: a nationwide population-based observational study2022

    • Author(s)
      Akira Funada, Yoshikazu Goto, Masayuki Takamura
    • Organizer
      AHA ReSS 2022
    • Related Report
      2022 Research-status Report
    • Int'l Joint Research
  • [Presentation] Differences of temporal trends in outcomes after out-of-hospital cardiac arrest between urban and rural regions in Japan: a 4-year observational study from 2016 to 20192022

    • Author(s)
      Akira Funada, Yoshikazu Goto
    • Organizer
      AHA ReSS 2022
    • Related Report
      2022 Research-status Report
    • Int'l Joint Research
  • [Presentation] Relationship between emergency medical service response time and bystander cardiopulmonary resuscitation in children with out-of-hospital cardiac arrest: A nationwide, population-based observational study2022

    • Author(s)
      Akira Funada, Yoshikazu Goto
    • Organizer
      AHA ReSS 2022
    • Related Report
      2022 Research-status Report
    • Int'l Joint Research
  • [Presentation] Association of subsequent shock after conversion to shockable rhythm with outcomes stratified by the type of initial non-shockable rhythm in children with out-of-hospital cardiac arrest2021

    • Author(s)
      Goto Yoshikazu、Funada Akira、Maeda Tetsuo、Goto Yumiko
    • Organizer
      European Heart Rhythm Association
    • Related Report
      2021 Research-status Report
    • Int'l Joint Research
  • [Presentation] Subsequent shock delivery and outcomes in out-of-hospital cardiac arrests with initial unshockable rhythm2021

    • Author(s)
      Goto Yoshikazu、Funada Akira、Maeda Tetsuo、Goto Yumiko
    • Organizer
      European Heart Rhythm Association
    • Related Report
      2021 Research-status Report
    • Int'l Joint Research
  • [Presentation] Bystander dispatcher-assisted cardiopulmonary resuscitation for the likelihood of an initial shockable rhythm after out-of-hospital cardiac arrest2021

    • Author(s)
      Goto Yoshikazu、Funada Akira、Maeda Tetsuo、Goto Yumiko
    • Organizer
      European Society of Cardiology
    • Related Report
      2021 Research-status Report
    • Int'l Joint Research
  • [Presentation] Dispatcher-assisted conventional cardiopulmonary resuscitation and outcomes for pediatric out-of-hospital cardiac arrests2021

    • Author(s)
      Goto Yoshikazu、Funada Akira、Maeda Tetsuo、Goto Yumiko
    • Organizer
      40th International Society of Intensive care and Emergency Medicine
    • Related Report
      2021 Research-status Report
    • Int'l Joint Research
  • [Presentation] Optimal instructions for dispatcher-assisted cardiopulmonary resuscitation for coaching callers after out-of-hospital cardiac arrests2021

    • Author(s)
      Goto Yoshikazu、Funada Akira、Maeda Tetsuo、Goto Yumiko
    • Organizer
      European Society of Intensive Care Medicine
    • Related Report
      2021 Research-status Report
    • Int'l Joint Research

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Published: 2021-04-28   Modified: 2024-12-25  

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