KITAMURA Tetsuhisa ≪Environmental Medicine and Population Sciences≫ “Public-Access Defibrillation and Out-of-Hospital Cardiac Arrest in Japan”

Publish The New England Journal of Medicine(2016) doi:10.1056/NEJMsa1600011

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Earlier defibrillation plays a key role in improving survival from out-of-hospital ventricular fibrillation (VF) arrest. The cumulative number of public-access automated external defibrillators (AEDs) in Japan reached over 420,000 in 2013. However, the impact of dissemination of public-access AEDs for VF arrest at the population level has not been sufficiently investigated. From the All-Japan Utstein Registry, we identified 43,762 bystander-witnessed VF of presumed cardiac origin with resuscitation attempts from 2005 through 2013. The proportion of favorable neurological outcome after bystander-witnessed VF arrest of cardiac origin was significantly higher in the public-access defibrillation (PAD) group than in the non-PAD group (38.5% versus 18.2%, adjusted odds ratio after propensity score matching 1.99). The estimated number of survivors with favorable neurological outcome attributed to PAD significantly increased from 6 in 2005 to 201 in 2013. In Japan, increased PAD by laypersons was associated with an increase in the number of survivors with favorable neurological outcome after VF arrest.
Kitamura T, Kiyohara K, Sakai T, Matsuyama T, Hatakeyama T, Shimamoto T, Izawa J, Fujii T, Nishiyama C, Kawamura T, Iwami T. Public-access defibrillation and out-of-hospital cardiac arrest in Japan. The New England Journal of Medicine 2016;375(17):1649-1659. DOI: 10.1056/NEJMsa1600011