Outcome assessment for out-of-hospital cardiac arrest patients in Singapore and Japan with initial shockable rhythm
Background: Singapore and Osaka in Japan have comparable population sizes and prehospital management; however, the frequency of ECPR differs greatly for out-of-hospital cardiac arrest (OHCA) patients with initial shockable rhythm. Given this disparity, we hypothesized that the outcomes among the OHC...
Saved in:
Main Authors: | , , , , , , , , , , , , , , , , , , |
---|---|
Other Authors: | |
Format: | Article |
Language: | English |
Published: |
2023
|
Subjects: | |
Online Access: | https://hdl.handle.net/10356/171529 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Institution: | Nanyang Technological University |
Language: | English |
id |
sg-ntu-dr.10356-171529 |
---|---|
record_format |
dspace |
institution |
Nanyang Technological University |
building |
NTU Library |
continent |
Asia |
country |
Singapore Singapore |
content_provider |
NTU Library |
collection |
DR-NTU |
language |
English |
topic |
Science::Medicine Out Of Hospital Cardiac Arrest Shockable Rhythm |
spellingShingle |
Science::Medicine Out Of Hospital Cardiac Arrest Shockable Rhythm Okada, Yohei Shahidah, Nur Ng, Yih Yng Chia, Michael Y. C. Gan, Han Nee Leong, Benjamin S. H. Mao, Desmond R. Ng, Wei Ming Irisawa, Taro Yamada, Tomoki Nishimura, Tetsuro Kiguchi, Takeyuki Kishimoto, Masafumi Matsuyama, Tasuku Nishioka, Norihiro Kiyohara, Kosuke Kitamura, Tetsuhisa Iwami, Taku Ong, Marcus Eng Hock Outcome assessment for out-of-hospital cardiac arrest patients in Singapore and Japan with initial shockable rhythm |
description |
Background: Singapore and Osaka in Japan have comparable population sizes and prehospital management; however, the frequency of ECPR differs greatly for out-of-hospital cardiac arrest (OHCA) patients with initial shockable rhythm. Given this disparity, we hypothesized that the outcomes among the OHCA patients with initial shockable rhythm in Singapore were different from those in Osaka. The aim of this study was to evaluate the outcomes of OHCA patients with initial shockable rhythm in Singapore compared to the expected outcomes derived from Osaka data using machine learning-based prediction models. Methods: This was a secondary analysis of two OHCA databases: the Singapore PAROS database (SG-PAROS) and the Osaka-CRITICAL database from Osaka, Japan. This study included adult (18–74 years) OHCA patients with initial shockable rhythm. A machine learning-based prediction model was derived and validated using data from the Osaka-CRITICAL database (derivation data 2012–2017, validation data 2018–2019), and applied to the SG-PAROS database (2010–2016 data), to predict the risk-adjusted probability of favorable neurological outcomes. The observed and expected outcomes were compared using the observed–expected ratio (OE ratio) with 95% confidence intervals (CI). Results: From the SG-PAROS database, 1,789 patients were included in the analysis. For OHCA patients who achieved return of spontaneous circulation (ROSC) on hospital arrival, the observed favorable neurological outcome was at the same level as expected (OE ratio: 0.905 [95%CI: 0.784–1.036]). On the other hand, for those who had continued cardiac arrest on hospital arrival, the outcomes were lower than expected (shockable rhythm on hospital arrival, OE ratio: 0.369 [95%CI: 0.258–0.499], and nonshockable rhythm, OE ratio: 0.137 [95%CI: 0.065–0.235]). Conclusion: This observational study found that the outcomes for patients with initial shockable rhythm but who did not obtain ROSC on hospital arrival in Singapore were lower than expected from Osaka. We hypothesize this is mainly due to differences in the use of ECPR. |
author2 |
Lee Kong Chian School of Medicine (LKCMedicine) |
author_facet |
Lee Kong Chian School of Medicine (LKCMedicine) Okada, Yohei Shahidah, Nur Ng, Yih Yng Chia, Michael Y. C. Gan, Han Nee Leong, Benjamin S. H. Mao, Desmond R. Ng, Wei Ming Irisawa, Taro Yamada, Tomoki Nishimura, Tetsuro Kiguchi, Takeyuki Kishimoto, Masafumi Matsuyama, Tasuku Nishioka, Norihiro Kiyohara, Kosuke Kitamura, Tetsuhisa Iwami, Taku Ong, Marcus Eng Hock |
format |
Article |
author |
Okada, Yohei Shahidah, Nur Ng, Yih Yng Chia, Michael Y. C. Gan, Han Nee Leong, Benjamin S. H. Mao, Desmond R. Ng, Wei Ming Irisawa, Taro Yamada, Tomoki Nishimura, Tetsuro Kiguchi, Takeyuki Kishimoto, Masafumi Matsuyama, Tasuku Nishioka, Norihiro Kiyohara, Kosuke Kitamura, Tetsuhisa Iwami, Taku Ong, Marcus Eng Hock |
author_sort |
Okada, Yohei |
title |
Outcome assessment for out-of-hospital cardiac arrest patients in Singapore and Japan with initial shockable rhythm |
title_short |
Outcome assessment for out-of-hospital cardiac arrest patients in Singapore and Japan with initial shockable rhythm |
title_full |
Outcome assessment for out-of-hospital cardiac arrest patients in Singapore and Japan with initial shockable rhythm |
title_fullStr |
Outcome assessment for out-of-hospital cardiac arrest patients in Singapore and Japan with initial shockable rhythm |
title_full_unstemmed |
Outcome assessment for out-of-hospital cardiac arrest patients in Singapore and Japan with initial shockable rhythm |
title_sort |
outcome assessment for out-of-hospital cardiac arrest patients in singapore and japan with initial shockable rhythm |
publishDate |
2023 |
url |
https://hdl.handle.net/10356/171529 |
_version_ |
1783955633333075968 |
spelling |
sg-ntu-dr.10356-1715292023-11-05T15:39:55Z Outcome assessment for out-of-hospital cardiac arrest patients in Singapore and Japan with initial shockable rhythm Okada, Yohei Shahidah, Nur Ng, Yih Yng Chia, Michael Y. C. Gan, Han Nee Leong, Benjamin S. H. Mao, Desmond R. Ng, Wei Ming Irisawa, Taro Yamada, Tomoki Nishimura, Tetsuro Kiguchi, Takeyuki Kishimoto, Masafumi Matsuyama, Tasuku Nishioka, Norihiro Kiyohara, Kosuke Kitamura, Tetsuhisa Iwami, Taku Ong, Marcus Eng Hock Lee Kong Chian School of Medicine (LKCMedicine) Tan Tock Seng Hospital Science::Medicine Out Of Hospital Cardiac Arrest Shockable Rhythm Background: Singapore and Osaka in Japan have comparable population sizes and prehospital management; however, the frequency of ECPR differs greatly for out-of-hospital cardiac arrest (OHCA) patients with initial shockable rhythm. Given this disparity, we hypothesized that the outcomes among the OHCA patients with initial shockable rhythm in Singapore were different from those in Osaka. The aim of this study was to evaluate the outcomes of OHCA patients with initial shockable rhythm in Singapore compared to the expected outcomes derived from Osaka data using machine learning-based prediction models. Methods: This was a secondary analysis of two OHCA databases: the Singapore PAROS database (SG-PAROS) and the Osaka-CRITICAL database from Osaka, Japan. This study included adult (18–74 years) OHCA patients with initial shockable rhythm. A machine learning-based prediction model was derived and validated using data from the Osaka-CRITICAL database (derivation data 2012–2017, validation data 2018–2019), and applied to the SG-PAROS database (2010–2016 data), to predict the risk-adjusted probability of favorable neurological outcomes. The observed and expected outcomes were compared using the observed–expected ratio (OE ratio) with 95% confidence intervals (CI). Results: From the SG-PAROS database, 1,789 patients were included in the analysis. For OHCA patients who achieved return of spontaneous circulation (ROSC) on hospital arrival, the observed favorable neurological outcome was at the same level as expected (OE ratio: 0.905 [95%CI: 0.784–1.036]). On the other hand, for those who had continued cardiac arrest on hospital arrival, the outcomes were lower than expected (shockable rhythm on hospital arrival, OE ratio: 0.369 [95%CI: 0.258–0.499], and nonshockable rhythm, OE ratio: 0.137 [95%CI: 0.065–0.235]). Conclusion: This observational study found that the outcomes for patients with initial shockable rhythm but who did not obtain ROSC on hospital arrival in Singapore were lower than expected from Osaka. We hypothesize this is mainly due to differences in the use of ECPR. Published version This study was supported by a scientific research grant from the JSPS KAKENHI of Japan (JP22K21143 to YO, JP22H03313 to TI, and JP22K09139 to TK), a research grant from the ZOLL Foundation, National Medical Research Council, Clinician Scientist Award, Singapore (NMRC/CSA/024/2010 and NMRC/ CSA/0049/2013) to MEHO, and Ministry of Health, Health Services Research Grant, Singapore (HSRG/0021/2012) to MEHO. 2023-10-30T01:11:17Z 2023-10-30T01:11:17Z 2023 Journal Article Okada, Y., Shahidah, N., Ng, Y. Y., Chia, M. Y. C., Gan, H. N., Leong, B. S. H., Mao, D. R., Ng, W. M., Irisawa, T., Yamada, T., Nishimura, T., Kiguchi, T., Kishimoto, M., Matsuyama, T., Nishioka, N., Kiyohara, K., Kitamura, T., Iwami, T. & Ong, M. E. H. (2023). Outcome assessment for out-of-hospital cardiac arrest patients in Singapore and Japan with initial shockable rhythm. Critical Care, 27(1), 351-. https://dx.doi.org/10.1186/s13054-023-04636-x 1364-8535 https://hdl.handle.net/10356/171529 10.1186/s13054-023-04636-x 37700335 2-s2.0-85170700398 1 27 351 en Critical Care © The Author(s) 2023. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. application/pdf |