Benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest: a community-based, observational study in Niigata, Japan.

Content Provider	Europe PMC
Author	Sato, Nobuhiro Matsuyama, Tasuku Akazawa, Kohei Nakazawa, Kyoko Hirose, Yasuo
Copyright Year	2019
Abstract	ObjectiveThis study aimed to assess the benefits of adding a physician-staffed ambulance to bystander-witnessed out-of-hospital cardiac arrest using a community-based registry.DesignPopulation-based, retrospective cohort study.SettingAn urban city with approximately 800 000 residents.ParticipantsPatients aged ≥18 years with bystander-witnessed out-of-hospital cardiac arrests of medical aetiology in Niigata City, Japan, between January 2012 and December 2016, according to the Utstein style.Primary and secondary outcome measuresThe primary outcome was 1-month survival with a favourable neurological outcome, defined as a cerebral performance category score of 1 or 2. We used logistic regression analysis to assess the association between favourable neurological outcome and prehospital physician involvement.ResultsDuring the study period, a total of 4172 cardiac arrests were registered; of these, 892 patients with out-of-hospital cardiac arrest were eligible for this analysis, among whom 135 (15.1%) had prehospital physician involvement and 757 (84.9%) did not have prehospital physician involvement. The percentage of favourable neurological outcomes was 20.7% (28 of 135) in those with physician involvement and 10.4% (79 of 757) in those without physician involvement (p=0.001). Using multivariable logistic regression, prehospital physician involvement had an OR for a favourable neurological outcome of 3.44 (95% CI 1.64 to 7.23).ConclusionsAmong adults with out-of-hospital cardiac arrest, adding a physician-staffed ambulance was associated with significantly greater favourable neurological outcomes than standard emergency medical services.
Journal	BMJ Open
Volume Number	9
PubMed Central reference number	PMC6887019
Issue Number	11
PubMed reference number	31772105
e-ISSN	20446055
DOI	10.1136/bmjopen-2019-032967
Language	English
Publisher	BMJ Publishing Group
Publisher Date	2019-11-26
Publisher Place	London
Access Restriction	Open
Rights License	This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Subject Keyword	advanced cardiac life support cardiopulmonary resuscitation emergency medical services out-of-hospital cardiac arrest physician
Content Type	Text
Resource Type	Article
Subject	Medicine