Background

Poisoning is an important cause of out-of-hospital cardiac arrest which can be challenging to manage. Neurological outcomes after poisoning-induced out-of-hospital cardiac arrest (POHCA) are yet to be fully elucidated. This retrospective cohort study sought to describe the characteristics of POHCA, and identify factors associated with favourable neurologic outcomes.

Methods

Cardiac arrests recorded in the “All Japan Utstein Registry” from 1 January 2012 to 31 December 2017 were included. A descriptive analysis of the characteristics of POHCA and non-POHCA patients was performed. Neurological outcomes were compared between the POHCA and non-POHCA groups using logistic regression analysis. Subgroup analysis was performed for patients who underwent prolonged resuscitation.

Results

Compared to non-POHCA patients (n = 665,262), POHCA patients (n = 1,868) were younger (median age, 80 vs 51 years) and had a lower likelihood of having a witness, bystander cardiopulmonary resuscitation, and an initial shockable rhythm. Multivariable logistic regression analysis showed that POHCA was associated with favourable neurologic outcomes (odds ratio 1.54, 95 % confidence interval 1.19–2.01, p = 0.001). Among patients who received > 30 min of resuscitation, neurologic outcomes were similar in those with POHCA and non-POHCA (favourable neurologic outcome, 1.03 % vs 0.98 %, p = 0.87).

Conclusions

POHCA is associated with favourable neurological outcomes and requires aggressive resuscitation. However, in patients who required prolonged resuscitation, the outcomes of POHCA were not different from those of non-POHCA. The decision to perform prolonged resuscitation should be guided on a case-by-case basis based on a range of factors.

中文翻译：

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日本中毒引起的心脏骤停的流行病学和临床结果：全国登记的回顾性分析

背景

中毒是院外心脏骤停的一个重要原因，处理起来非常困难。中毒引起的院外心脏骤停（POHCA）后的神经学结果尚未完全阐明。这项回顾性队列研究旨在描述 POHCA 的特征，并确定与良好神经系统结果相关的因素。

方法

2012年1月1日至2017年12月31日期间“全日本Utstein登记处”记录的心脏骤停也被纳入其中。对 POHCA 和非 POHCA 患者的特征进行了描述性分析。使用逻辑回归分析比较 POHCA 组和非 POHCA 组之间的神经学结果。对接受长时间复苏的患者进行亚组分析。

结果

与非 POHCA 患者 (n = 665,262) 相比，POHCA 患者 (n = 1,868) 更年轻（中位年龄为 80 岁 vs 51 岁），并且有目击者、旁观者心肺复苏和初始可电击心律的可能性较低。多变量逻辑回归分析显示，POHCA 与良好的神经系统结局相关（比值比 1.54，95% 置信区间 1.19–2.01，p  = 0.001）。在接受 > 30 分钟复苏的患者中，POHCA 和非 POHCA 患者的神经系统结果相似（良好的神经系统结果，1.03 % vs 0.98 %，p  = 0.87）。

结论

POHCA 与良好的神经系统结果相关，需要积极的复苏。然而，在需要长时间复苏的患者中，POHCA 的结果与非 POHCA 的结果没有差异。进行长时间复苏的决定应根据一系列因素根据具体情况进行指导。