title: Shorter time until return of spontaneous circulation is the only independent factor for a good neurological outcome in patients with postcardiac arrest syndrome.
abstract: OBJECTIVE
  Few studies have reported factors that result in a better neurological outcome in patients with postcardiac arrest syndrome (PCAS) following return of spontaneous circulation (ROSC). We investigated the factors affecting neurological outcome in terms of both prehospital care and treatments after arrival at hospital in patients with PCAS.
  
  
  METHODS
  The study enrolled patients with cardiogenic cardiac arrest who were admitted to an intensive care unit after ROSC with PCAS. We investigated the association of the following factors with outcome: age, gender, witness to event present, bystander cardiopulmonary resuscitation (CPR) performed, ECG waveform at the scene, time interval from receipt of call to arrival of emergency personnel, time interval from receipt of call to arrival at hospital, prehospital defibrillation performed, special procedures performed by emergency medical technician, and time interval from receipt of call to ROSC, coronary angiography/percutaneous coronary intervention (PCI) and therapeutic hypothermia performed.
  
  
  RESULTS
  The study enrolled 227 patients with PCAS. Compared with the poor neurological outcome group, the good neurological outcome group had a statistically significant higher proportion of the following factors: younger age, male, witness present, bystander CPR performed, first ECG showed ventricular fibrillation/pulseless ventricular tachycardia, defibrillation performed during transportation, short time interval from receipt of call to ROSC, coronary angiography/PCI and therapeutic hypothermia performed. Of these factors, the only independent factor associated with good neurological outcome was the short time interval from receipt of the call to ROSC.
  
  
  CONCLUSIONS
  In the present study, shortening time interval from receipt of call to ROSC was the only important independent factor to achieve good neurological outcome in patients with PCAS.
authors: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
authors: Tomohide
authors: T
authors: Komatsu
authors: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
authors: Kosaku
authors: K
authors: Kinoshita
authors: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
authors: Atsushi
authors: A
authors: Sakurai
authors: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
authors: Takashi
authors: T
authors: Moriya
authors: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
authors: Junko
authors: J
authors: Yamaguchi
authors: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
authors: Atsunori
authors: A
authors: Sugita
authors: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
authors: Rikimaru
authors: R
authors: Kogawa
authors: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
authors: Katsuhisa
authors: K
authors: Tanjoh
mesh_terms: D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology* / Q000517:prevention & control*; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D011379:Prognosis; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
keywords: cardiac arrest; cardiac care, treatment; emergency ambulance systems, effectiveness; emergency care systems, efficiency; resuscitation
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