title: Characteristics and Outcomes of Bath-Related Out-of-Hospital Cardiac Arrest in Japan.
abstract: BACKGROUND
  Characteristics and outcomes of emergency patients with bath-related sudden cardiac arrest in prehospital settings have not been sufficiently investigated.
  
  
  RESULTS
  From a prospective population-based registry, which covers all out-of-hospital cardiac arrests (OHCAs) in Osaka City, a total of 642 patients who had a bath-related OHCA from 2012 to 2014 were enrolled in the analyses. The characteristics and outcomes of OHCA were compared by three locations of arrest: home baths (n=512), public baths (n=102), and baths in other public institutions (n=28). Overall, bath-related OHCAs mainly occurred in winter (December-February, 48.9%, 314/642). The proportion of OHCAs that were witnessed by bystanders was 6.4% (33/512) in home baths, 17.6% (18/102) in public baths, and 25.0% (7/28) in baths in other public institutions. The proportion of public-access automated external defibrillator pad application was 0.8% (4/512) in home baths, 6.9% (7/102) in public baths, and 50.0% (14/28) in baths in other public institutions. Only 1 survivor with a favorable neurologic outcome was observed in a home bath, whereas there were no patients who survived with favorable neurologic outcomes in public baths and baths in other public institutions.
  
  
  CONCLUSIONS
  Bath-related OHCAs mainly occurred in winter, and the outcome of victims was exceedingly poor, irrespective of location of arrest. The establishment of preventive measures as well as earlier recognition of cardiac arrest by bystanders are needed. (Circ J 2016; 80: 1564-1570).
authors.affiliation: Department of Public Health, Tokyo Women's Medical University.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kiyohara
authors.forename: Chika
authors.initials: C
authors.lastname: Nishiyama
authors.forename: Sumito
authors.initials: S
authors.lastname: Hayashida
authors.forename: Tasuku
authors.initials: T
authors.lastname: Matsuyama
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Hatakeyama
authors.forename: Tomonari
authors.initials: T
authors.lastname: Shimamoto
authors.forename: Junichi
authors.initials: J
authors.lastname: Izawa
authors.forename: Tomoko
authors.initials: T
authors.lastname: Fujii
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Katayama
authors.forename: Taku
authors.initials: T
authors.lastname: Iwami
authors.forename: Tetsuhisa
authors.initials: T
authors.lastname: Kitamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001494:Baths / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000209:etiology / Q000401:mortality*; D011446:Prospective Studies; D012042:Registries; D012621:Seasons