Survival rate and factors associated with 1-month survival of witnessed out-of-hospital cardiac arrest of cardiac origin with ventricular fibrillation and pulseless ventricular tachycardia: the Utstein Osaka project.
OBJECTIVE
We reassessed 1-month survival of patients with witnessed out-of-hospital cardiac arrest (OHCA) of cardiac origin with ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) in Osaka, Japan, and identified factors associated with 1-month survival using updated data from 1998 to 2004 collected based on the Utstein Style.


METHODS
Using the Utstein Osaka Project database, we analyzed 1028 cases which met the following criteria: (1) patient age 18 years or older; (2) presumed cardiac origin based on the definition of the Utstein Style; (3) witnessed by citizens; (4) VF or pulseless VT at the time of arrival of the ambulance. The main outcome measure was survival at 1 month after collapse. Variables to develop a predictive model for 1-month survival were selected by stepwise logistic regression.


RESULTS
Survival at 1 month was 19.6%. Factors retained in the final logistic regression were age, sex, type of witness, and time interval from (a) ambulance call receipt to cardiopulmonary resuscitation (CPR) by the ambulance crew; (b) ambulance call to defibrillation; (c) CPR by the ambulance crew to hospital arrival. Area under the receiver-operating characteristic curve for the model developed with the six variables was 0.738 and Hosmer-Lemshow goodness-of-fit p-value was 0.94.


CONCLUSIONS
We successfully developed a model to estimate the probability of 1-month survival using variables easy to collect in the early phase of resuscitation, and this model would help physicians and family members predict the likelihood of 1-month survival of OHCA patients on admission.
Osaka Prefectural Senshu Critical Care Medical Center, 2-24 Rinku-Orai Kita, Izumisano City, Osaka 598-0048, Japan. nishiuchi@sccmc.izumisano.osaka.jp
Tatsuya
T
Nishiuchi
Yasuaki
Y
Hayashino
Shunichi
S
Fukuhara
Taku
T
Iwami
Yasuyuki
Y
Hayashi
Atsushi
A
Hiraide
Hisashi
H
Ikeuchi
Hidekazu
H
Yukioka
Tetsuya
T
Matsuoka
D000293:Adolescent; D000328:Adult; D000368:Aged; D004562:Electrocardiography; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000150:complications* / Q000401:mortality* / Q000503:physiopathology; D014693:Ventricular Fibrillation / Q000150:complications* / Q000401:mortality* / Q000503:physiopathology; D055815:Young Adult