日本多中心全国性观察性研究（JAAM-OHCA注册研究）中，主动脉内球囊反搏在可电击除颤的院外心脏骤停患者中的应用：倾向加权分析
Intra-Aortic Balloon Pump among Shockable Out-of-Hospital Cardiac Arrest Patients: A Propensity-Weighted Analysis in a Multicenter, Nationwide Observational Study in Japan (The JAAM-OHCA Registry).
作者信息
Yoshimura Satoshi, Kiguchi Takeyuki, Irisawa Taro, Yamada Tomoki, Yoshiya Kazuhisa, Park Changhwi, Nishimura Tetsuro, Ishibe Takuya, Kobata Hitoshi, Kishimoto Masafumi, Kim Sung-Ho, Ito Yusuke, Sogabe Taku, Morooka Takaya, Sakamoto Haruko, Suzuki Keitaro, Onoe Atsunori, Matsuyama Tasuku, Matsui Satoshi, Nishioka Norihiro, Okada Yohei, Makino Yuto, Kimata Shunsuke, Kawai Shunsuke, Zha Ling, Kiyohara Kosuke, Kitamura Tetsuhisa, Iwami Taku
机构信息
Department of Preventive Services, Kyoto University School of Public Health, Kyoto 606-8317, Japan.
Critical Care and Trauma Center, Osaka General Medical Center, Osaka 558-8558, Japan.
出版信息
J Clin Med. 2023 Sep 13;12(18):5945. doi: 10.3390/jcm12185945.
BACKGROUND
The effectiveness of IABP for shockable out-of-hospital cardiac arrest (OHCA) has not been extensively investigated. This study aimed to investigate whether the use of an intra-aortic balloon pump (IABP) for non-traumatic shockable OHCA patients was associated with favorable neurological outcomes.
METHODS
From the Japanese Association for Acute Medicine Out-of-Hospital Cardiac Arrest registry, a nationwide multicenter prospective registry, we enrolled adult patients with non-traumatic and shockable OHCA for whom resuscitation was attempted, and who were transported to participating hospitals between 2014 and 2019. The primary outcome was 1-month survival with favorable neurological outcomes after OHCA. After adopting the propensity score (PS) inverse probability of weighting (IPW), we evaluated the association between IABP and favorable neurological outcomes.
RESULTS
Of 57,754 patients in the database, we included a total of 2738 adult non-traumatic shockable patients. In the original cohort, the primary outcome was lower in the IABP group (OR with 95% confidence intervals (CIs)), 0.57 (0.48-0.68), whereas, in the IPW cohort, it was not different between patients with and without IABP (OR, 1.18; 95% CI, 0.91-1.53).
CONCLUSION
In adult patients with non-traumatic shockable OHCA, IABP use was not associated with 1-month survival with favorable neurological outcomes.
背景
主动脉内球囊反搏（IABP）用于可电击除颤的院外心脏骤停（OHCA）的有效性尚未得到广泛研究。本研究旨在调查主动脉内球囊泵（IABP）用于非创伤性可电击除颤的OHCA患者是否与良好的神经功能结局相关。
方法
从日本急性医学协会院外心脏骤停登记处（一个全国性多中心前瞻性登记处），我们纳入了尝试进行复苏的非创伤性可电击除颤的OHCA成年患者，这些患者在2014年至2019年期间被转运至参与研究的医院。主要结局是OHCA后1个月存活且神经功能良好。采用倾向评分（PS）逆概率加权（IPW）后，我们评估了IABP与良好神经功能结局之间的关联。
结果
数据库中的57754例患者中，我们共纳入了2738例成年非创伤性可电击除颤患者。在原始队列中，IABP组的主要结局较低（比值比（OR）及95%置信区间（CI）），为0.57（0.48 - 0.68），而在IPW队列中，使用IABP与未使用IABP的患者之间无差异（OR，1.18；95%CI，0.91 - 1.53）。
结论
在成年非创伤性可电击除颤的OHCA患者中，使用IABP与1个月存活且神经功能良好无关。
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