Hirata Kaiho, Chiba Takuyo, Hosono Kazuki, Tsuji Haruka, Ikeda Shunya, Shiga Takashi
Department of Emergency Medicine, International University of Health and Welfare Narita Hospital, Narita, Chiba, Japan
Department of Emergency Medicine, International University of Health and Welfare Narita Hospital, Narita, Chiba, Japan.
BMJ Open. 2024 Dec 31;14(12):e089500. doi: 10.1136/bmjopen-2024-089500.
To compare the neurological outcomes of out-of-hospital cardiac arrest due to anaphylaxis (OHCA-A) and cardiac causes (OHCA-C).
Retrospective observational study.
Japanese nationwide dataset from 2012 to 2021.
In total, 153 890 patients were included in this study, of which 331 had OHCA-A and 153 559 had OHCA-C.
The primary outcome was a favourable neurological outcome 1 month after cardiac arrest. The secondary outcome was survival at 1 month.
Patients with OHCA-A had a significantly higher favourable neurological outcome rate (24.2% vs 11.7%, p<0.001) and higher survival rate at 1 month (33.2% vs 16.1%, p<0.001) than patients with OHCA-C. Multivariable logistic regression analysis revealed that OHCA-A was associated with higher odds of favourable neurological outcomes (adjusted OR (adj OR): 1.86; 95% CI 1.34 to 2.59) and survival at 1 month (adj OR: 2.43; 95% CI 1.78 to 3.31). Similarly, the propensity score-matched cohort showed favourable neurological outcomes in patients with OHCA-A (OR: 2.91; 95% CI 1.83 to 4.65).
Compared with OHCA-C, OHCA-A is associated with favourable neurological outcomes and warrants more aggressive resuscitation efforts.
比较过敏性反应导致的院外心脏骤停（OHCA-A）和心脏原因导致的院外心脏骤停（OHCA-C）的神经学预后。
回顾性观察研究。
2012年至2021年日本全国性数据集。
本研究共纳入153890例患者，其中331例为OHCA-A，153559例为OHCA-C。
主要结局是心脏骤停后1个月时良好的神经学预后。次要结局是1个月时的存活情况。
OHCA-A患者的良好神经学预后率显著高于OHCA-C患者（24.2%对11.7%，p<0.001），1个月时的存活率也更高（33.2%对16.1%，p<0.001）。多变量逻辑回归分析显示，OHCA-A与良好神经学预后（调整后的比值比（adj OR）：1.86；95%置信区间1.34至2.59）和1个月时存活的较高几率相关（adj OR：2.43；95%置信区间1.78至3.31）。同样，倾向评分匹配队列显示OHCA-A患者有良好的神经学预后（OR：2.91；95%置信区间1.83至4.65）。
与OHCA-C相比，OHCA-A与良好的神经学预后相关，值得更积极的复苏努力。
