2023 Fiscal Year Final Research Report
Prediction chart for neurological outcomes of elderly patients with out-of-hospital cardiac arrest and the corresponding time to termination of resuscitation
Project/Area Number |
19K10555
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Research Category |
Grant-in-Aid for Scientific Research (C)
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Allocation Type | Multi-year Fund |
Section | 一般 |
Review Section |
Basic Section 58010:Medical management and medical sociology-related
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Research Institution | Kanazawa University |
Principal Investigator |
Funada Akira 金沢大学, 医学系, 協力研究員 (20602626)
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Project Period (FY) |
2019-04-01 – 2024-03-31
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Keywords | 院外心停止 / 高齢者 / 蘇生処置 / 救急医療 / 事前指示 / 医療倫理 |
Outline of Final Research Achievements |
We evaluated elderly patients with out-of-hospital cardiac arrest (OHCA) of cardiac origin who achieved prehospital return of spontaneous circulation (ROSC). The primary outcome was 1-month neurologically intact survival, defined as a cerebral performance category (CPC) score of 1-2. Patients with OHCA were divided into 12 groups according to age (65-74, 75-89, and 90 years or over), shockable rhythm (YES/NO), and witness status (YES/NO). The time from call receipt to ROSC at which the probability of 1-month CPC 1-2 decreased to <1% was defined as the call to termination of resuscitation (TOR) duration. Neurological outcomes and the appropriate call to TOR duration differed according to patient characteristics, including age. Our prediction chart for elderly patients with OHCA could be useful for determining TOR in the field or at the emergency department.
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Free Research Field |
医歯薬学
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Academic Significance and Societal Importance of the Research Achievements |
本研究で作成された神経学的転帰良好予測表を根拠として、高齢院外心停止例の蘇生処置不要の事前指示が救急現場で受け入れられるようになれば、救急現場で高齢者と家族の希望に沿った蘇生処置の差し控え、看取りを実現できると考える。また家族の心理的負担の軽減、満足度の向上、さらに救急隊、救急医療関係者、地域の医療や介護・福祉の関係者の負担の軽減や医療資源活用の効率化等に貢献すると考えられる。 本研究は、今後、さらなる増加が予想される高齢院外心停止例に対する国民の理解・意識改革、および病院前救護体制の改革に一役を担い、社会的、経済的、倫理的に非常に意義があると考える。
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