Tanaka Yoshio, Tanaka Koichi, Ushimoto Tomoyuki, Inaba Hideo
Department of Emergency and Disaster Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, JPN.
Department of Emergency Medicine, Kanazawa Medical University, Uchinada, JPN.
Cureus. 2025 Mar 6;17(3):e80168. doi: 10.7759/cureus.80168. eCollection 2025 Mar.
Background The impact of the coronavirus disease 2019 (COVID-19) pandemic on out-of-hospital cardiac arrest (OHCA) occurring in this setting remains unclear. Objective The objective of this study is to elucidate the impact of the COVID-19 pandemic on the prehospital characteristics and outcomes of OHCA occurring in the workplace. Methods This nationwide observational study in Japan was a retrospective analysis and included 16,364 non-emergency medical service witnessed and adult workplace OHCAs. The characteristics and outcomes of workplace OHCAs were compared between the pre-pandemic period (2016-2019) and the pandemic period (2020-2021). Furthermore, subgroup analyses were performed for workplace location (office vs. non-office) and infection burden region. Results During the pandemic period, no significant changes were observed in incidence, public access defibrillation (PAD) provision rates, one-month survival rates, or neurologically favorable survival rates. However, increases were observed for bystander cardiopulmonary resuscitation (CPR) (crude odds rate (cOR), 95% confidence interval (CI): 1.10, 1.02-1.16; P<0.001), particularly compression-only CPR. The multivariable analysis revealed that the impact of the pandemic was similarly seen in an increase in bystander CPR (adjusted OR, 95% CI: 1.14, 1.06-1.22; P<0.001). Furthermore, the monthly changes in only PAD were altered biennially (PAD: P=0.02, bystander CPR: P=0.52, one-month survival: P=0.26, and neurologically favorable one-month survival: P=0.48). Analysis restricted to high-infection burden regions revealed that only the PAD rate decreased (P=0.03). Conclusion The COVID-19 pandemic had no impact on OHCA survival in workplaces and had a limited positive impact on bystander responses. This may be attributed to previous positive CPR training experiences and routine preparation for health crises.
2019年冠状病毒病（COVID-19）大流行对在此背景下发生的院外心脏骤停（OHCA）的影响尚不清楚。目的：本研究的目的是阐明COVID-19大流行对工作场所发生的OHCA的院前特征和结局的影响。方法：这项在日本进行的全国性观察性研究是一项回顾性分析，纳入了16364例非紧急医疗服务见证的成人工作场所OHCA。比较了大流行前时期（2016 - 2019年）和大流行时期（2020 - 2021年）工作场所OHCA的特征和结局。此外，还对工作场所位置（办公室与非办公室）和感染负担地区进行了亚组分析。结果：在大流行期间，发病率、公众可获取除颤（PAD）提供率、1个月生存率或神经功能良好生存率均未观察到显著变化。然而，旁观者心肺复苏（CPR）有所增加（粗比值比（cOR），95%置信区间（CI）：1.10，1.02 - 1.16；P<0.001），尤其是仅胸外按压的CPR。多变量分析显示，大流行的影响同样表现为旁观者CPR的增加（调整后OR，95%CI：1.14，1.06 - 1.22；P<0.001）。此外，仅PAD的月度变化呈两年期改变（PAD：P = 0.02，旁观者CPR：P = 0.52，1个月生存率：P = 0.26，神经功能良好的月生存率：P = 0.48）。仅限于高感染负担地区的分析显示，仅PAD率下降（P = 0.03）。结论：COVID-19大流行对工作场所OHCA的生存没有影响，对旁观者反应的积极影响有限。这可能归因于先前积极的CPR培训经历和对健康危机的常规准备。
