Evaluation of a revised resuscitation protocol for out-of-hospital cardiac arrest patients due to COVID-19 safety protocols: a single-center retrospective study in Japan

Abstract This study aimed to determine the association between cardiopulmonary resuscitation (CPR) under the coronavirus 2019 (COVID-19) safety protocols in our hospital and the prognosis of out-of-hospital cardiac arrest (OHCA) patients, in an urban area, where the prevalence of COVID-19 infection...

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Autores principales:	Kenji Kandori, Yohei Okada, Wataru Ishii, Hiromichi Narumiya, Ryoji Iizuka
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dc10b1bf94a9416ea1f1b842f1bcb5c3
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spelling	oai:doaj.org-article:dc10b1bf94a9416ea1f1b842f1bcb5c32021-12-02T16:07:02ZEvaluation of a revised resuscitation protocol for out-of-hospital cardiac arrest patients due to COVID-19 safety protocols: a single-center retrospective study in Japan10.1038/s41598-021-92415-52045-2322https://doaj.org/article/dc10b1bf94a9416ea1f1b842f1bcb5c32021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92415-5https://doaj.org/toc/2045-2322Abstract This study aimed to determine the association between cardiopulmonary resuscitation (CPR) under the coronavirus 2019 (COVID-19) safety protocols in our hospital and the prognosis of out-of-hospital cardiac arrest (OHCA) patients, in an urban area, where the prevalence of COVID-19 infection is relatively low. This was a single-center, retrospective, observational, cohort study conducted at a tertiary critical care center in Kyoto City, Japan. Adult OHCA patients arriving at our hospital under CPR between January 1, 2019, and December 31, 2020 were included. Our hospital implemented a revised resuscitation protocol for OHCA patients on April 1, 2020 to prevent COVID-19 transmission. This study defined the conventional CPR period as January 1, 2019 to March 31, 2020, and the COVID-19 safety protocol period as April 1, 2020 to December 31, 2020. Throughout the prehospital and in-hospital settings, resuscitation protocols about wearing personal protective equipment and airway management were revised in order to minimize the risk of infection; otherwise, the other resuscitation management had not been changed. The primary outcome was hospitalization survival. The secondary outcomes were return of spontaneous circulation after hospital arrival and 1-month survival after OHCA occurrence. The adjusted odds ratios with 95% confidence intervals (CI) were calculated for outcomes to compare the two study periods, and the multivariable logistic model was used to adjust for potential confounders. The study analyzed 443 patients, with a median age of 76 years (65–85), and included 261 men (58.9%). The percentage of hospitalization survivors during the entire research period was 16.9% (75/443 patients), with 18.7% (50/267) during the conventional CPR period and 14.2% (25/176) during the COVID-19 safety protocol period. The adjusted odds ratio for hospitalization survival during the COVID-19 safety protocol period was 0.61 (95% CI 0.32–1.18), as compared with conventional CPR. There were no cases of COVID-19 infection among the staff involved in the resuscitation in our hospital. There was no apparent difference in hospitalization survival between the OHCA patients resuscitated under the conventional CPR protocol compared with the current revised protocol for controlling COVID-19 transmission.Kenji KandoriYohei OkadaWataru IshiiHiromichi NarumiyaRyoji IizukaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kenji Kandori Yohei Okada Wataru Ishii Hiromichi Narumiya Ryoji Iizuka Evaluation of a revised resuscitation protocol for out-of-hospital cardiac arrest patients due to COVID-19 safety protocols: a single-center retrospective study in Japan
description	Abstract This study aimed to determine the association between cardiopulmonary resuscitation (CPR) under the coronavirus 2019 (COVID-19) safety protocols in our hospital and the prognosis of out-of-hospital cardiac arrest (OHCA) patients, in an urban area, where the prevalence of COVID-19 infection is relatively low. This was a single-center, retrospective, observational, cohort study conducted at a tertiary critical care center in Kyoto City, Japan. Adult OHCA patients arriving at our hospital under CPR between January 1, 2019, and December 31, 2020 were included. Our hospital implemented a revised resuscitation protocol for OHCA patients on April 1, 2020 to prevent COVID-19 transmission. This study defined the conventional CPR period as January 1, 2019 to March 31, 2020, and the COVID-19 safety protocol period as April 1, 2020 to December 31, 2020. Throughout the prehospital and in-hospital settings, resuscitation protocols about wearing personal protective equipment and airway management were revised in order to minimize the risk of infection; otherwise, the other resuscitation management had not been changed. The primary outcome was hospitalization survival. The secondary outcomes were return of spontaneous circulation after hospital arrival and 1-month survival after OHCA occurrence. The adjusted odds ratios with 95% confidence intervals (CI) were calculated for outcomes to compare the two study periods, and the multivariable logistic model was used to adjust for potential confounders. The study analyzed 443 patients, with a median age of 76 years (65–85), and included 261 men (58.9%). The percentage of hospitalization survivors during the entire research period was 16.9% (75/443 patients), with 18.7% (50/267) during the conventional CPR period and 14.2% (25/176) during the COVID-19 safety protocol period. The adjusted odds ratio for hospitalization survival during the COVID-19 safety protocol period was 0.61 (95% CI 0.32–1.18), as compared with conventional CPR. There were no cases of COVID-19 infection among the staff involved in the resuscitation in our hospital. There was no apparent difference in hospitalization survival between the OHCA patients resuscitated under the conventional CPR protocol compared with the current revised protocol for controlling COVID-19 transmission.
format	article
author	Kenji Kandori Yohei Okada Wataru Ishii Hiromichi Narumiya Ryoji Iizuka
author_facet	Kenji Kandori Yohei Okada Wataru Ishii Hiromichi Narumiya Ryoji Iizuka
author_sort	Kenji Kandori
title	Evaluation of a revised resuscitation protocol for out-of-hospital cardiac arrest patients due to COVID-19 safety protocols: a single-center retrospective study in Japan
title_short	Evaluation of a revised resuscitation protocol for out-of-hospital cardiac arrest patients due to COVID-19 safety protocols: a single-center retrospective study in Japan
title_full	Evaluation of a revised resuscitation protocol for out-of-hospital cardiac arrest patients due to COVID-19 safety protocols: a single-center retrospective study in Japan
title_fullStr	Evaluation of a revised resuscitation protocol for out-of-hospital cardiac arrest patients due to COVID-19 safety protocols: a single-center retrospective study in Japan
title_full_unstemmed	Evaluation of a revised resuscitation protocol for out-of-hospital cardiac arrest patients due to COVID-19 safety protocols: a single-center retrospective study in Japan
title_sort	evaluation of a revised resuscitation protocol for out-of-hospital cardiac arrest patients due to covid-19 safety protocols: a single-center retrospective study in japan
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/dc10b1bf94a9416ea1f1b842f1bcb5c3
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Evaluation of a revised resuscitation protocol for out-of-hospital cardiac arrest patients due to COVID-19 safety protocols: a single-center retrospective study in Japan

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