title: Rationale, design, and profile of Comprehensive Registry of In-Hospital Intensive Care for OHCA Survival (CRITICAL) study in Osaka, Japan.
abstract: BACKGROUND
  We established a multi-center, prospective cohort that could provide appropriate therapeutic strategies such as criteria for the introduction and the effectiveness of in-hospital advanced treatments, including percutaneous coronary intervention (PCI), target temperature management, and extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) patients.
  
  
  METHODS
  In Osaka Prefecture, Japan, we registered all consecutive patients who were suffering from an OHCA for whom resuscitation was attempted and who were then transported to institutions participating in this registry since July 1, 2012. A total of 11 critical care medical centers and one hospital with an emergency care department participated in this registry. The primary outcome was neurological status after OHCA, defined as cerebral performance category (CPC) scale.
  
  
  RESULTS
  A total of 688 OHCA patients were documented between July 2012 and December 2012. Of them, 657 were eligible for our analysis. Patients' average age was 66.2 years old, and male patients accounted for 66.2 %. The proportion of OHCAs having a cardiac origin was 50.4 %. The proportion as first documented rhythm of ventricular fibrillation/pulseless ventricular tachycardia was 11.6 %, pulseless electrical activity 23.4 %, and asystole 54.5 %. After hospital arrival, 10.5 % received defibrillation, 90.8 % tracheal intubation, 3.0 % ECPR, 3.5 % PCI, and 83.1 % adrenaline administration. The proportions of 90-day survival and CPC 1/2 at 90 days after OHCAs were 5.9 and 3.0 %, respectively.
  
  
  CONCLUSIONS
  The Comprehensive Registry of In-hospital Intensive Care for OHCA Survival (CRITICAL) study will enroll over 2000 OHCA patients every year. It is still ongoing without a set termination date in order to provide valuable information regarding appropriate therapeutic strategies for OHCA patients (UMIN000007528).
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan ; Emergency and Critical Care Medical Center, Osaka Police Hospital, Osaka, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan.
authors.forename: Tetsuhisa
authors.initials: T
authors.lastname: Kitamura
authors.affiliation: Department of Emergency and Critical Care Medicine, Kansai Medical University, Takii Hospital, Moriguchi, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Hayakawa
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Yoshiya
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Irisawa
authors.affiliation: Department of Emergency Medicine, Tane General Hospital, Osaka, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Department of Critical Care Medicine, Osaka City University, Osaka, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Ishiro
authors.affiliation: Department of Emergency and Critical Care Medicine, Kinki University School of Medicine, Osaka-Sayama, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Uejima
authors.affiliation: Osaka Mishima Emergency Critical Care Center, Takatsuki, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohishi
authors.affiliation: Department of Critical Care Medicine, Osaka City University, Osaka, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Kaneda
authors.affiliation: Critical Care and Trauma Center, Osaka General Medical Center, Osaka, Japan.
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Kiguchi
authors.affiliation: Emergency and Critical Care Medical Center, Osaka Police Hospital, Osaka, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kishi
authors.affiliation: Osaka Prefectural Nakakawachi Medical Center of Acute Medicine, Higashi-Osaka, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kishimoto
authors.affiliation: Senshu Trauma and Critical Care Center, Osaka, Japan.
authors.forename: Shota
authors.initials: S
authors.lastname: Nakao
authors.affiliation: Traumatology and Critical Care Medical Center, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Nishimura
authors.affiliation: Senri Critical Care Medical Center, Saiseikai Senri Hospital, Suita, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan.
authors.forename: Takaya
authors.initials: T
authors.lastname: Morooka
authors.affiliation: Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto, 606-8501 Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Izawa
authors.affiliation: Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto, 606-8501 Japan.
authors.forename: Tomonari
authors.initials: T
authors.lastname: Shimamoto
authors.affiliation: Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto, 606-8501 Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Hatakeyama
authors.affiliation: Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto, 606-8501 Japan.
authors.forename: Tasuku
authors.initials: T
authors.lastname: Matsuyama
authors.affiliation: Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto, 606-8501 Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawamura
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimazu
authors.affiliation: Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto, 606-8501 Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Iwami
keywords: CRITICAL; Cohort; In-hospital intensive care; Out-of-hospital cardiac arrest; Outcome
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