Association between physician-staffed ambulances and patient prognoses after out-of-hospital cardiac arrests with respect to shockable and non-shockable rhythms: a retrospective observational study in a southern area of Shiga Prefecture Japan.

• Material Type: 博士論文
• Title: Association between physician-staffed ambulances and patient prognoses after out-of-hospital cardiac arrests with respect to shockable and non-shockable rhythms: a retrospective observational study in a southern area of Shiga Prefecture Japan.
• Volume: 6 3
• Author/Editor: 加藤, 文崇; KATO, Fumitaka
• Author Heading: 加藤, 文崇; KATO, Fumitaka
• Publication, Distribution, etc.: John Wiley and Sons, Inc
• Publication Date: 2019-03-12
• Publication Date (W3CDTF): 2019-03-12
• Degree grantor/type: 滋賀医科大学
• Date Granted: 2019-09-11
• Date Granted (W3CDTF): 2019-09-11
• Dissertation Number: 乙第444号
• Degree Type: 博士（医学）
• Conferring No. (Dissertation): 乙第444号
• Text Language Code: eng
• Subject Heading: Out‐of‐hospital cardiac arrest; physician‐staffed ambulance; return of spontaneous circulation
• Target Audience: 一般
• Note (General): Aim:Out-of-hospital cardiac arrests (OHCA) are a significant public health problem; to improve patients' prognoses, various interventions, such as providing physician-staffed ambulances, have been implemented. We aimed to examine whether physician-staffed ambulances were associated with patients' prognoses after OHCA with respect to first-monitored rhythms.; Methods:This retrospective observational study was undertaken between 1 September 2011 and 31 December 2015, using data based on Utstein-style guidelines. We extracted data on age, sex, first-monitored rhythm (shockable or non-shockable), presence of a witness, bystander cardiopulmonary resuscitation, time from call to arrival at the scene, out-of-hospital adrenaline administration, out-of-hospital intubation, return of spontaneous circulation before arrival at the hospital, and survival and neurological outcomes 30 days after OHCA, according to cerebral performance categories. We undertook logistic regression analyses to assess the association between physician-staffed ambulances and patients' prognoses.; Results:A total of 882 OHCA patients were eligible for this study. Physician-staffed ambulances attended to 164 OHCA patients. Multivariable analysis found that in non-shockable rhythm patients, physician-staffed ambulances significantly improved good neurological outcome (odds ratio, 3.65; 95% confidence interval [CI], 1.28-10.50; P = 0.02), return of spontaneous circulation before arrival at the hospital (odds ratio, 2.68; 95% CI, 1.62-4.42; P < 0.001), and 30-day survival (odds ratio, 2.90; 95% CI, 1.30-6.45; P = 0.009). However, physician-staffed ambulances were not associated with patient prognoses in shockable rhythm patients.; Conclusion:Despite our study's limitations, physician-staffed ambulances might be associated with good neurological outcomes in non-shockable rhythm patients. Our observations could provide more appropriate prehospital treatment options for OHCA patients.; Thesis or Dissertation; 令和元年度; 10.1002/ams2.405; 博士論文要旨
• DOI: info:doi/10.1002/ams2.405; https://doi.org/info:doi/10.1002/ams2.405
• Persistent ID (NDL): info:ndljp/pid/11551848; https://dl.ndl.go.jp/pid/11551848
• Collection: 障害者向け資料
• Collection (Materials For Handicapped People:1): テキストデータ
• Collection (particular): 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• Acquisition Basis: 博士論文（自動収集）
• Date Accepted (W3CDTF): 2020-10-06T21:18:06+09:00
• Date Created (W3CDTF): 2020-09-17
• Format (IMT): application/pdf
• Access Restrictions: 国立国会図書館内限定公開
• Service for the Digitized Contents Transmission Service: 図書館・個人送信対象外
• Availability of remote photoduplication service: 可
• Related Material (URI): http://hdl.handle.net/10422/00012670
• Periodical Title (URI): http://hdl.handle.net/10422/00012797; https://shiga-med.repo.nii.ac.jp/records/3683
• Data Provider (Database): 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp

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