Aim: The current study compares pre- and in-hospital management and outcomes of out-of-hospital cardiac arrest cases between 2002 and 2012 in the Kanto region of Japan.
Methods: We compared the data collected for the SOS-KANTO study project in 2002 and 2012. We included adult patients (aged >18 years) who experienced bystander-witnessed out-of-hospital cardiac arrest of cardiac etiology. The outcomes were as follows: proportion of favorable neurological outcomes at 1 month, bystander cardiopulmonary resuscitation provision, and pre- and postresuscitation treatment administration.
Results: Of 4,171 patients (1,982 in SOS-KANTO in 2002 and 2,189 in 2012), the proportion of those with favorable neurological outcomes at 1 month (4.8% versus 9.0%, P < 0.001), and bystander cardiopulmonary resuscitation rates increased significantly between 2002 and 2012 (24.5% versus 38.9%, P < 0.001). Although none were documented in 2002, 118 cases (5.4%) of layperson use of an automated external defibrillator were recorded in 2012. Relative to 2002, use of an i.v. line to provide fluid was more frequently attempted and carried out successfully by emergency medical service providers in 2012. Among cases in which return of spontaneous circulation was achieved, more postresuscitation treatment was provided in 2012 (13.3% versus 43.8%, P < 0.001) relative to that provided in 2002.
Conclusions: Proportions of bystander cardiopulmonary resuscitation, layperson use of automated external defibrillator, provision of prehospital adrenaline and postresuscitation treatment, and favorable neurological outcomes at 1 month increased significantly over 10 years in the Kanto region of Japan.
Keywords: Adrenaline; automated external defibrillator; emergency medical services; extracorporeal life support; hypothermia.