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. 2022 Dec:12:100299.
doi: 10.1016/j.resplu.2022.100299. Epub 2022 Sep 6.

Impact of the COVID-19 pandemic on out-of-hospital cardiac arrest outcomes in older adults in Japan

Sanae Hosomi  1   2 , Ling Zha  2 , Kosuke Kiyohara  3 , Tetsuhisa Kitamura  2 , Sho Komukai  4 , Tomotaka Sobue  2 , Jun Oda  1
Affiliations

Impact of the COVID-19 pandemic on out-of-hospital cardiac arrest outcomes in older adults in Japan

Sanae Hosomi et al. Resusc Plus. 2022 Dec.

Abstract

Aim: The coronavirus disease (COVID-19) pandemic has negatively affected access to healthcare and treatment. This study aimed to explore the impact of the COVID-19 pandemic on older adults with out-of-hospital cardiac arrest (OHCA) in Japan, a country with a super-aging society.

Methods: This secondary analysis of the All-Japan Utstein Registry included patients aged 65 years and older with bystander-witnessed OHCA between January 1, 2005, and December 31, 2020. Survival outcomes were compared by time period using multivariable logistic regression analyses. The primary outcome measured was the one-month survival rate with neurologically favorable outcomes.

Results: Before the COVID-19 pandemic, survival outcomes were steadily improving, and 32,024 patients in 2019 and 31,894 in 2020 were eligible for analysis. The proportions of conventional cardiopulmonary resuscitation and shock by public-access automated external defibrillators were lower in 2020 than in 2019 (6.7% versus 5.7%, p < 0.001 and 2.5% versus 2.1%, p < 0.001, respectively). Compared to 2019, the one-month survival after OHCA and prehospital return of spontaneous circulation decreased significantly in 2020 than in 2019 (7.7% versus 6.6%, adjusted odds ratio [AOR]: 0.88, 95% confidence interval [CI]: 0.83-0.94, and 16.8% versus 14.9%, AOR: 0.87, 95% CI: 0.83-0.91, respectively). The proportion of neurologically favorable outcomes also decreased, but the decrease was not statistically significant (3.4% versus 2.8%, AOR: 0.92, 95% CI: 0.83-1.01).

Conclusion: In this population-focused, bystander-witnessed study regarding OHCA, the analysis of nationwide registry data revealed that the COVID-19 pandemic was associated with reduced survival among older adults with OHCA in Japan.

Keywords: COVID-19 pandemic; Older adults; Out-of-hospital cardiac arrest; Survival outcomes.

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Figures

Fig. 1
Fig. 1
Flow chart of patient selection, Patients aged 65 years or older with bystander-witnessed out-of-hospital cardiac arrests in Japan during 2005–2020 were included in this study. COVID-19, coronavirus disease; EMS, emergency medical service; OHCA, out-of-hospital cardiac arrest.
Fig. 2
Fig. 2
Trend of survival outcomes in this study, the trend bars are based on an analysis of 1,490,510 patients aged 65 years or older with bystander-witnessed out-of-hospital cardiac arrest during 2005–2020. P-values for trend were included in the analysis. ROSC, return of spontaneous circulation.
Fig. 3
Fig. 3
Outcomes of patients with bystander-witnessed out-of-hospital cardiac arrest by month in 2019 and 2020 with the state of emergency period highlighted using a box, ROSC, return of spontaneous circulation.
See this image and copyright information in PMC

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