Outcomes of out-of-hospital ventricular fibrillation: their association with time to defibrillation and related issues in the defibrillation program in Japan.
The aim of this study was to provide data on the outcomes of out-of-hospital cardiac arrest caused by ventricular fibrillation (VFOHCA) and analyze factors influencing patient outcomes in order to further improve EMS system performance in the resuscitation of VFOHCA patients in Japan. A datasheet was mailed to the fire defense headquarters throughout Japan, and returned data were analyzed for 614 cases of VFOHCA that occurred from January 1 through December 31, 1996. In relation to the time interval from receipt of emergency call to defibrillation, the subjects were stratified into five groups: 0-8 (n = 39), 9-12 (n = 87), 13-16 (n = 154), 17-20 (n = 118) and more than 21 min (n = 216). The discharge survival rates were 18*, 13.8*, 5.2, 4.2 and 4.2%, respectively (*P < 0.05). When defibrillation was delivered within 12 min after a call, 30.2% (38/126) converted to pulse-generating rhythm (PGR) after defibrillation and 43.6% (17/39) of patients with PGR on arrival at the hospital survived to discharge. In spite of these findings, a marked delay to defibrillation (more than 13 min) was observed in the majority (79.5%). The data shown in this study demonstrated that important issues that limit the benefits of an early defibrillation program reside in the EMS system.
Tanigawa
K
K
Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, Jonanku, Japan. tanigawa@fukuoka-u.ac.jp
Tanaka
K
K
Shigematsu
A
A
D000328:Adult; D000368:Aged; D004554:Electric Countershock; D004632:Emergency Medical Services; D005260:Female; D006760:Hospitalization; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000628:therapy*