Incidence and outcomes of in-hospital cardiac arrest in Japan 2011–2017: a nationwide inpatient database study
Tóm tắt
Although numerous studies have investigated out-of-hospital cardiac arrest, few studies have been conducted on in-hospital cardiac arrest (IHCA). Knowledge of the nationwide epidemiology of IHCA in Japan, with its super-aging society, is important to understand the current situation of IHCA and to establish evidenced-based medicine in the future. The present study aimed to determine the incidence and outcomes of IHCA and their trends in Japan. This observational cohort study was performed using a national administrative inpatient database for more than 1600 acute-care hospitals covering about 50% of all acute-care hospital beds in Japan from April 2011 to March 2018. We defined cardiac arrest patients who received cardiopulmonary resuscitation (chest compression) during hospitalization as IHCA. We excluded out-of-hospital cardiac arrest patients from the source population. The incidence of IHCA per 1000 hospital admissions and survival to discharge rate was reported with trend analyses by calendar year 2011–2017. Among 53,871,101 hospitalized patients without out-of-hospital cardiac arrest patients in 1626 hospitals, 2,136,038 (4.0%) had cardiac arrest. Of them, 274,664 (12.9%) received cardiopulmonary resuscitation at least once during hospitalization and were identified as IHCA, and 1,861,374 (87.1%) did not receive cardiopulmonary resuscitation. The incidence of IHCA per 1000 hospital admissions was 5.1, with a significant decreasing trend from 6.1 in 2011 to 4.6 in 2017 (P for trend = 0.033). Our estimated incidence can be translated to approximately 87,000 IHCA cases in Japan each year. The percentage of IHCA patients among cardiac arrest patients was 12.9%, with a significant decreasing trend from 14.0% in 2011 to 12.2% in 2017 (P for trend = 0.006). The overall rate of survival to discharge was 12.7%, with a significant increasing trend from 10.5% in 2011 to 14.0% in 2017 (P for trend < 0.001). We found substantial associations between mortality and loss of health and IHCA in Japan. The incidence of IHCA showed a decreasing trend over time, the percentage of treated cardiac arrest patients also had a decreasing trend, and the overall survival to discharge rate improved over time.
Tài liệu tham khảo
Andersen LW, Holmberg MJ, Berg KM, Donnino MW, Granfeldt A. In-hospital cardiac arrest: a review. JAMA. 2019;321:1200–10.
Tunstall-Pedoe H, Bailey L, Chamberlain DA, Marsden AK, Ward ME, Zideman DA. Survey of 3765 cardiopulmonary resuscitations in British hospitals (the BRESUS Study): methods and overall results. BMJ. 1992;304:1347–51.
Peberdy MA, Kaye W, Ornato JP, Larkin GL, Nadkarni V, Mancini ME, et al. Cardiopulmonary resuscitation of adults in the hospital: a report of 14720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation. 2003;58:297–308.
Iwami T, Nichol G, Hiraide A, Hayashi Y, Nishiuchi T, Kajino K, et al. Continuous improvements in ‘chain of survival’ increased survival after out-of-hospital cardiac arrests: a large-scale population-based study. Circulation. 2009;119:728–34.
Kitamura T, Iwami T, Kawamura T, Nagao K, Tanaka H, Hiraide A, Implementation Working Group for the All-Japan Utstein Registry of the Fire and Disaster Management Agency. Nationwide public-access defibrillation in Japan. N Engl J Med. 2010;362:994–1004.
Kitamura T, Kiyohara K, Sakai T, Matsuyama T, Hatakeyama T, Shimamoto T, et al. Public-access defibrillation and out-of-hospital cardiac arrest in Japan. N Engl J Med. 2016;375:1649–59.
Merchant RM, Yang L, Becker LB, Berg RA, Nadkarni V, Nichol G, American Heart Association Get with the Guidelines-Resuscitation Investigators, et al. Incidence of treated cardiac arrest in hospitalized patients in the United States. Crit Care Med. 2011;39:2401–6.
Nolan JP, Soar J, Smith GB, Gwinnutt C, Parrott F, Power S, National Cardiac Arrest Audit, et al. Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit. Resuscitation. 2014;85:987–92.
Sandroni C, Nolan J, Cavallaro F, Antonelli M. In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intensive Care Med. 2007;33:237–45.
Morrison LJ, Neumar RW, Zimmerman JL, Link MS, Newby LK, McMullan PW, American Heart Association Emergency Cardiovascular Care Committee, Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Peripheral Vascular Disease, et al. Strategies for improving survival after in-hospital cardiac arrest in the United States: 2013 consensus recommendations: a consensus statement from the American Heart Association. Circulation. 2013;127:1538–63.
Yokoyama H, Yonemoto N, Yonezawa K, Fuse J, Shimizu N, Hayashi T, J-RCPR Investigators, et al. Report from the Japanese registry of CPR for in-hospital cardiac arrest (J-RCPR). Circ J. 2011;75:815–22.
Fujiwara S, Koike T, Moriyasu M, Nakagawa M, Atagi K, Lefor AK, IHCA Study Group, et al. A retrospective study of in-hospital cardiac arrest. Acute Med Surg. 2016;3:320–5.
Yasunaga H. Real world data in Japan: Chapter II the diagnosis procedure combination database. Ann Clin Epidemiol. 2019;1:76–9.
Yamana H, Moriwaki M, Horiguchi H, Kodan M, Fushimi K, Yasunaga H. Validity of diagnoses, procedures, and laboratory data in Japanese administrative data. J Epidemiol. 2017;27:476–82.
Nolan JP, Berg RA, Andersen LW, Bhanji F, Chan PS, Donnino MW, et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update of the utstein resuscitation registry template for in-hospital cardiac arrest: a consensus report from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia). Circulation. 2019;140:e746–57.
Nolan JP, Berg RA, Andersen LW, Bhanji F, Chan PS, Donnino MW, Utstein Collaborators, et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update of the Utstein Resuscitation Registry Template for in-hospital cardiac arrest: a consensus report from a Task Force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia). Resuscitation. 2019;144:166–77.
Shigematsu K, Nakano H, Watanabe Y. The eye response test alone is sufficient to predict stroke outcome—reintroduction of Japan Coma Scale: a cohort study. BMJ Open. 2013;3:e002736.
Armitage P. Tests for linear trends in proportions and frequencies. Biometrics. 1955;11:375–86.
Jonckheere AR. A distribution-free k-sample test against ordered alternatives. Biometrika. 1954;41:133–45.
The Ministry of Health, Labour and Welfare. Japan statistical surveys 2017. The Ministry of Health, Labour and Welfare, Japan; 2017. https://www.mhlw.go.jp/english.html.
Fire and Disaster Management Agency. Report on a study on social system development to improve survival from emergency cardiovascular disease. https://www.fdma.go.jp/publication/rescue/post7.html. (in Japanese)
Holmberg MJ, Ross CE, Fitzmaurice GM, Chan PS, Duval-Arnould J, Grossestreuer AV, American Heart Association’s Get With The Guidelines–Resuscitation Investigators, et al. Annual incidence of adult and pediatric in-hospital cardiac arrest in the United States. Circ Cardiovasc Qual Outcomes. 2019;12:e005580.
WHO Mortality Database—WHO. https://www.who.int/data/data-collection-tools/who-mortality-database.html.
Ministry of Health, Labour and Welfare. https://www.mhlw.go.jp/english/database/db-hw/vs01.html.
Makino J, Fujitani S, Twohig B, Krasnica S, Oropello J. End-of-life considerations in the ICU in Japan: ethical and legal perspectives. J Intensive Care. 2014;2:9.
Jones DA, DeVita MA, Bellomo R. Rapid-response teams. N Engl J Med. 2011;365:139–46.
Maharaj R, Raffaele I, Wendon J. Rapid response systems: a systematic review and meta-analysis. Crit Care. 2015;19:254.
Girotra S, Nallamothu BK, Spertus JA, Li Y, Krumholz HM, Chan PS, American Heart Association Get with the Guidelines–Resuscitation Investigators. Trends in survival after in-hospital cardiac arrest. N Engl J Med. 2012;367:1912–20.
Schluep M, Gravesteijn BY, Stolker RJ, Endeman H, Hoeks SE. One-year survival after in-hospital cardiac arrest: a systematic review and meta-analysis. Resuscitation. 2018;132:90–100.
Merchant RM, Topjian AA, Panchal AR, Cheng A, Aziz K, Berg KM, Adult Basic and Advanced Life Support, Pediatric Basic and Advanced Life Support, Neonatal Life Support, Resuscitation Education Science, and Systems of Care Writing Groups, et al. Part 1: executive summary: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020;142:S337–57.
Perkins GD, Graesner JT, Semeraro F, Olasveengen T, Soar J, Lott C, European Resuscitation Council Guideline Collaborators, et al. European Resuscitation Council guidelines 2021: executive summary. Resuscitation. 2021;161:1–60.
Sebat F, Musthafa AA, Johnson D, Kramer AA, Shoffner D, Eliason M, et al. Effect of a rapid response system for patients in shock on time to treatment and mortality during 5 years. Crit Care Med. 2007;35:2568–75.
Jennett B, Bond M. Assessment of outcome after severe brain damage. Lancet. 1975;1:480–4.