Overview and future prospects of out-of-hospital cardiac arrest registries in Japan

Yohei Okada; Koshi Nakagawa; Hideharu Tanaka; Haruka Takahashi; Tetsuhisa Kitamura; Takeyuki Kiguchi; Norihiro Nishioka; Nobuya Kitamura; Takashi Tagami; Akihiko Inoue; Toru Hifumi; Tetsuya Sakamoto; Yasuhiro Kuroda; Taku Iwami

doi:10.1016/j.resplu.2024.100578

Overview and future prospects of out-of-hospital cardiac arrest registries in Japan

Resusc Plus. 2024 Feb 10:17:100578. doi: 10.1016/j.resplu.2024.100578. eCollection 2024 Mar.

Authors

Yohei Okada^{1

2}, Koshi Nakagawa³, Hideharu Tanaka³, Haruka Takahashi⁴, Tetsuhisa Kitamura⁵, Takeyuki Kiguchi^{2

6}, Norihiro Nishioka², Nobuya Kitamura⁷, Takashi Tagami⁸, Akihiko Inoue⁹, Toru Hifumi¹⁰, Tetsuya Sakamoto¹¹, Yasuhiro Kuroda¹², Taku Iwami²

Affiliations

¹ Health Services and Systems Research, Duke-NUS Medical School, Singapore.
² Department of Preventive Services, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
³ Graduate School of Emergency Medical System, Kokushikan University, Japan.
⁴ Medical Science, Nippon Sport Science University, Tokyo, Japan.
⁵ Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
⁶ Department of Emergency and Critical Care, Osaka General Medical Center, Osaka, Japan.
⁷ Department of Emergency and Critical Care Medicine, Kimitsu Chuo Hospital, Kisarazu-shi, Chiba, Japan.
⁸ Department of Emergency and Critical Care Medicine, Nippon Medical School Musashikosugi Hospital.
⁹ Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, Hyogo, Japan.
¹⁰ Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan.
¹¹ Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan.
¹² Department of Emergency, Disaster and Critical Care Medicine, Kagawa University Hospital, Kagawa, Japan.

Abstract

Aim: Out-of-hospital cardiac arrest (OHCA) is a life-threatening emergency with high mortality. The "chain of survival" is critical to improving patient outcomes. To develop and enhance this chain of survival, measuring and monitoring the resuscitation processes and outcomes are essential for quality assurance. In Japan, several OHCA registries have successfully been implemented at both local and national levels. We aimed to review and summarise the conception, strengths, and challenges of OHCA registries in Japan.

Method and results: The following representing registries in Japan were reviewed: the All-Japan Utstein registry, the Utstein Osaka Project/the Osaka-CRITICAL study, the SOS-KANTO study, the JAAM-OHCA study, and the SAVE-J II study. The All-Japan Utstein registry, operated by the Fire and Disaster Management Agency of Japan and one of the largest nationwide population-based registries in the world, collects data concerning all patients with OHCA in Japan, excluding in-hospital data. Other research- and hospital-based registries collect detailed out-of-hospital and in-hospital data. The Osaka-CRITICAL study and the SOS-KANTO study are organized at regional levels, and hospitals in the Osaka prefecture and in the Kanto area participate in these registries. The JAAM-OHCA study is managed by the Japanese Association of Acute Medicine and includes 107 hospitals throughout Japan. The Save-J II study focuses on patients with OHCA treated with extracorporeal cardiopulmonary resuscitation.

Conclusion: Each OHCA registry has its own philosophy, strengths, perspectives, and challenges; however, all have been successful in contributing to the improvement of emergency medical service (EMS) systems through the quality improvement process. These registries are expected to be further utilized to enhance EMS systems and improve outcomes for patients with OHCA, while also contributing to the field of resuscitation science.

Keywords: Cardiac arrest; Emergency medicine; Epidemiology; Resuscitation.

Publication types

Review