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8 results on '"Takuya Ishibe"'

1. Non-linear association between the time required to reaching temperature targets and the neurological outcome in patients undergoing targeted temperature management after out-of-hospital cardiac arrest: Observational multicentre cohort study

Author

Tetsuro Nishimura, Toshihiro Hatakeyama, Hisako Yoshida, Satoshi Yoshimura, Takeyuki Kiguchi, Taro Irisawa, Tomoki Yamada, Kazuhisa Yoshiya, Changhwi Park, Takuya Ishibe, Yoshiki Yagi, Masafumi Kishimoto, Sung-Ho Kim, Yasuyuki Hayashi, Yusuke Ito, Taku Sogabe, Takaya Morooka, Haruko Sakamoto, Keitaro Suzuki, Fumiko Nakamura, Tasuku Matsuyama, Yohei Okada, Norihiro Nishioka, Satoshi Matsui, Shunsuke Kimata, Shunsuke Kawai, Yuto Makino, Tetsuhisa Kitamura, Taku Iwami, and Yasumitsu Mizobata

Subjects
Cardiac arrest, Cardiopulmonary resuscitation, Emergency medical services, Emergency medicine, Resuscitation, Targeted temperature management, Specialties of internal medicine, RC581-951
Abstract

Purpose: We evaluated associations between outcomes and time to achieving temperature targets during targeted temperature management of out-of-hospital cardiac arrest. Methods: Using Comprehensive Registry of Intensive Care for out-of-hospital cardiac arrest Survival (CRITICAL) study, we enrolled all patients transported to participating hospitals from 1 July 2012 through 31 December 2017 aged ≥ 18 years with out-of-hospital cardiac arrest of cardiac aetiology and who received targeted temperature management in Osaka, Japan. Primary outcome was Cerebral Performance Category scale of 1 or 2 one month after cardiac arrest, designated as “one-month favourable neurological outcome”. Non-linear multivariable logistic regression analyses assessed the primary outcome based on time to reaching temperature targets. In patients subdivided into quintiles based on time to achieving temperature targets, multivariable logistic regression calculated adjusted odds ratios and 95% confidence intervals. Results: We analysed 473 patients. In non-linear multivariable logistic regression analysis, p value for non-linearity was < 0.01. In the first quintile (< 26.7 minutes), second quintile (26.8–89.9 minutes), third quintile (90.0–175.1 minutes), fourth quintile (175.2–352.1 minutes), and fifth quintile (≥ 352.2 minutes), one-month favourable neurological outcome was 32.6% (31/95), 40.0% (36/90), 53.5% (53/99), 57.4% (54/94), and 37.9% (36/95), respectively. Adjusted odds ratios with 95% confidence intervals for one-month favourable neurological outcome in the first, second, third, and fifth quintiles compared with the fourth quintile were 0.38 (0.20 to 0.72), 0.43 (0.23 to 0.81), 0.77 (0.41 to 1.44), and 0.46 (0.25 to 0.87), respectively. Conclusion: Non-linear multivariable logistic regression analysis could clearly describe the association between neurological outcome in patients with out-of-hospital cardiac arrest and the time from the introduction of targeted temperature management to reaching the temperature targets.

Published
2024
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2. Association between initial body temperature on hospital arrival and neurological outcome among patients with out-of-hospital cardiac arrest: a multicenter cohort study (the CRITICAL study in Osaka, Japan)

Author

Satoshi Yoshimura, Takeyuki Kiguchi, Taro Irisawa, Tomoki Yamada, Kazuhisa Yoshiya, Changhwi Park, Tetsuro Nishimura, Takuya Ishibe, Yoshiki Yagi, Masafumi Kishimoto, Sung-Ho Kim, Yasuyuki Hayashi, Taku Sogabe, Takaya Morooka, Haruko Sakamoto, Keitaro Suzuki, Fumiko Nakamura, Tasuku Matsuyama, Yohei Okada, Norihiro Nishioka, Satoshi Matsui, Shunsuke Kimata, Shunsuke Kawai, Yuto Makino, Tetsuhisa Kitamura, Taku Iwami, and on behalf of the, CRITICAL Study Group Investigators

Subjects
Out-of-hospital cardiac arrest, Initial body temperature, Cardiopulmonary resuscitation, Neurological outcomes, Special situations and conditions, RC952-1245, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background The association between spontaneous initial body temperature on hospital arrival and neurological outcomes has not been sufficiently studied in patients after out-of-hospital cardiac arrest (OHCA). Methods From the prospective database of the Comprehensive Registry of Intensive Care for OHCA Survival (CRITICAL) study in Osaka, Japan, we enrolled all patients with OHCA of medical origin aged > 18 years for whom resuscitation was attempted and who were transported to participating hospitals between 2012 and 2019. We excluded patients who were not witnessed by bystanders and treated by a doctor car or helicopter, which is a car/helicopter with a physician. The patients were categorized into three groups according to their temperature on hospital arrival: ≤35.9 °C, 36.0–36.9 °C (normothermia), and ≥ 37.0 °C. The primary outcome was 1-month survival, with a cerebral performance category of 1 or 2. Multivariable logistic regression analyses were performed to evaluate the association between temperature and outcomes (normothermia was used as the reference). We also assessed this association using cubic spline regression analysis. Results Of the 18,379 patients in our database, 5014 witnessed adult OHCA patients of medical origin from 16 hospitals were included. When analyzing 3318 patients, OHCA patients with an initial body temperature of ≥37.0 °C upon hospital arrival were associated with decreased favorable neurological outcomes (6.6% [19/286] odds ratio, 0.51; 95% confidence interval, 0.27–0.95) compared to patients with normothermia (16.4% [180/1100]), whereas those with an initial body temperature of ≤35.9 °C were not associated with decreased favorable neurological outcomes (11.1% [214/1932]; odds ratio, 0.78; 95% confidence interval, 0.56–1.07). The cubic regression splines demonstrated that a higher body temperature on arrival was associated with decreased favorable neurological outcomes, and a lower body temperature was not associated with decreased favorable neurological outcomes. Conclusions In adult patients with OHCA of medical origin, a higher body temperature on arrival was associated with decreased favorable neurologic outcomes.

Published
2022
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3. Clinical Phenotyping of Out-of-Hospital Cardiac Arrest Patients With Shockable Rhythm ― Machine Learning-Based Unsupervised Cluster Analysis ―

Author

Tasuku Matsuyama, Taku Iwami, Yasuyuki Hayashi, Shigeru Ohtsuru, Daisuke Kobayashi, Satoshi Yoshimura, Masafumi Kishimoto, Haruko Sakamoto, Tomoki Yamada, Takuya Ishibe, Sho Komukai, Taro Irisawa, Yohei Okada, Norihiro Nishioka, Kazuhisa Yoshiya, Taku Sogabe, Satoshi Matsui, Takaya Morooka, Tetsuro Nishimura, Yoshiki Yagi, Fumiko Nakamura, Takeshi Shimazu, Toshiya Inoue, Keitaro Suzuki, Changhwi Park, Shunsuke Kimata, Tetsuhisa Kitamura, Atsushi Hirayama, and Takeyuki Kiguchi

Subjects
Adult, medicine.medical_specialty, Subphenotype, Disease cluster, Clustering, Out of hospital cardiac arrest, Machine Learning, Extracorporeal Membrane Oxygenation, Latent class analysis, Internal medicine, medicine, Retrospective analysis, Cluster Analysis, Humans, Extracorporeal cardiopulmonary resuscitation, Ventricular fibrillation, Retrospective Studies, business.industry, General Medicine, Shockable rhythm, Cardiac arrest, medicine.disease, Cardiopulmonary Resuscitation, Latent class model, Observational study, Cardiology and Cardiovascular Medicine, business, Out-of-Hospital Cardiac Arrest
Abstract

BACKGROUND: The hypothesis of this study is that latent class analysis could identify the subphenotypes of out-of-hospital cardiac arrest (OHCA) patients associated with the outcomes and allow us to explore heterogeneity in the effects of extracorporeal cardiopulmonary resuscitation (ECPR).Methods and Results:This study was a retrospective analysis of a multicenter prospective observational study (CRITICAL study) of OHCA patients. It included adult OHCA patients with initial shockable rhythm. Patients from 2012 to 2016 (development dataset) were included in the latent class analysis, and those from 2017 (validation dataset) were included for evaluation. The association between subphenotypes and outcomes was investigated. Further, the heterogeneity of the association between ECPR implementation and outcomes was explored. In the study results, a total of 920 patients were included for latent class analysis. Three subphenotypes (Groups 1, 2, and 3) were identified, mainly characterized by the distribution of partial pressure of O2(PO2), partial pressure of CO2(PCO2) value of blood gas assessment, cardiac rhythm on hospital arrival, and estimated glomerular filtration rate. The 30-day survival outcomes were varied across the groups: 15.7% in Group 1; 30.7% in Group 2; and 85.9% in Group 3. Further, the association between ECPR and 30-day survival outcomes by subphenotype groups in the development dataset was as varied. These results were validated using the validation dataset. CONCLUSIONS: The latent class analysis identified 3 subphenotypes with different survival outcomes and potential heterogeneity in the effects of ECPR.

Published
2022

4. Trends in In-Hospital Advanced Management and Survival of Out-of-Hospital Cardiac Arrest Among Adults From 2013 to 2017 ― A Multicenter, Prospective Registry in Osaka, Japan ―

Author

Yasuyuki Hayashi, Kazuhisa Yoshiya, Tomoki Yamada, Takeyuki Kiguchi, Yoshiki Yagi, Shunsuke Kimata, Tasuku Matsuyama, Tetsuhisa Kitamura, Atsushi Hirayama, Takuya Ishibe, Satoshi Matsui, Takaya Morooka, Satoshi Yoshimura, Toshiya Inoue, Fumiko Nakamura, Taro Irisawa, Haruko Sakamoto, Keitaro Suzuki, Changhwi Park, Takeshi Shimazu, Norihiro Nishioka, Taku Sogabe, Taku Iwami, Yohei Okada, Daisuke Kobayashi, Masafumi Kishimoto, and Tetsuro Nishimura

Subjects
Adult, Resuscitation, medicine.medical_specialty, Adolescent, medicine.medical_treatment, 030204 cardiovascular system & hematology, Out of hospital cardiac arrest, 03 medical and health sciences, 0302 clinical medicine, Japan, Intensive care, Survival trend, Humans, Medicine, Extracorporeal cardiopulmonary resuscitation, Prospective Studies, Registries, 030212 general & internal medicine, Cardiopulmonary resuscitation, business.industry, Neurological status, General Medicine, Odds ratio, Cardiopulmonary Resuscitation, Hospitals, Confidence interval, Emergency medicine, Patient management, Cardiology and Cardiovascular Medicine, business, Out-of-Hospital Cardiac Arrest
Abstract

BACKGROUND: The aim of our study was to investigate in detail the temporal trends in in-hospital characteristics, actual management, and survival, including neurological status, among adult out-of-hospital cardiac arrest (OHCA) patients in recent years.Methods and Results:From the prospective database of the Comprehensive Registry of Intensive Care for OHCA Survival (CRITICAL) study in Osaka, Japan, we enrolled all OHCA patients aged ≥18 years for whom resuscitation was attempted, and who were transported to participating hospitals between the years 2013 and 2017. The primary outcome measure was 1-month survival with favorable neurological outcome after OHCA. Temporal trends in in-hospital management and favorable neurological outcome among adult OHCA patients were assessed. Of the 11, 924 patients in the database, we included a total of 10, 228 adult patients from 16 hospitals. As for in-hospital advanced treatments, extracorporeal cardiopulmonary resuscitation (ECPR) use increased from 2.4% in 2013 to 4.3% in 2017 (P for trend

Published
2021

5. Clinical outcomes among out-of-hospital cardiac arrest patients treated by extracorporeal cardiopulmonary resuscitation: The CRITICAL study in Osaka

Author

Yohei Okada, Taro Irisawa, Tomoki Yamada, Kazuhisa Yoshiya, Changhwi Park, Tetsuro Nishimura, Takuya Ishibe, Hitoshi Kobata, Takeyuki Kiguchi, Masafumi Kishimoto, Sung-Ho Kim, Yusuke Ito, Taku Sogabe, Takaya Morooka, Haruko Sakamoto, Keitaro Suzuki, Atsunori Onoe, Tasuku Matsuyama, Daisuke Kobayashi, Norihiro Nishioka, Satoshi Matsui, Satoshi Yoshimura, Shunsuke Kimata, Shunsuke Kawai, Yuto Makino, Kosuke Kiyohara, Ling Zha, Tetsuhisa Kitamura, and Taku Iwami

Subjects
Adult, Extracorporeal Membrane Oxygenation, Adolescent, Emergency Medicine, Humans, Prospective Studies, Registries, Emergency Nursing, Cardiology and Cardiovascular Medicine, Cardiopulmonary Resuscitation, Out-of-Hospital Cardiac Arrest, Aged, Retrospective Studies
Abstract

Extracorporeal cardiopulmonary resuscitation (ECPR) is performed in refractory out-of-hospital cardiac arrest (OHCA) patients, and the eligibility has been conventionally determined based on three criteria (initial cardiac rhythm, time to hospital arrival within 45 minutes, and age75 years) in Japan. Owing to limited information, this study descriptively determined neurological outcomes after applying the three criteria among OHCA patients who underwent ECPR.This study conducted a post-hoc analysis of data from the Comprehensive Registry of Intensive Care for OHCA Survival (CRITICAL) study. This was a multi-institutional prospective observational study of OHCA patients in Osaka Prefecture, Japan. All adult (aged ≥18 years) OHCA patients with internal medical causes treated with ECPR between 1 July 2012 and 31 December 2019 were evaluated. We described one-month neurological favourable outcomes based on the three criteria (initial shockable, time to hospital arrival within 45 minutes, and age75 years), and we compared them using the chi-square test.Among 18,379 patients screened from the CRITICAL study database, we included 517 OHCA patients treated by ECPR; 311 (60.2%) patients met all three criteria. Favourable neurological outcomes were as follows: patients meeting no or one criterion: 2.3% (1/43), those meeting two criteria: 8% (13/163), and those meeting all criteria: 16.1% (50/311) (P-value = 0.004).In this study, approximately 60% of patients treated by ECPR met the three criteria (initial shockable, time to hospital arrival within 45 minutes, and age75 years), and the greater the number of criteria met, the better were the neurological outcomes achieved.

Published
2022

6. Early prognostic impact of serum sodium level among out-of-hospital cardiac arrest patients: a nationwide multicentre observational study in Japan (the JAAM-OHCA registry)

Author

Haruka, Shida, Tasuku, Matsuyama, Sho, Komukai, Taro, Irisawa, Tomoki, Yamada, Kazuhisa, Yoshiya, Changhwi, Park, Tetsuro, Nishimura, Takuya, Ishibe, Yoshiki, Yagi, Takeyuki, Kiguchi, Masafumi, Kishimoto, Sung-Ho, Kim, Yasuyuki, Hayashi, Taku, Sogabe, Takaya, Morooka, Haruko, Sakamoto, Keitaro, Suzuki, Fumiko, Nakamura, Norihiro, Nishioka, Yohei, Okada, Satoshi, Matsui, Satoshi, Yoshimura, Shunsuke, Kimata, Shunsuke, Kawai, Yuto, Makino, Taku, Iwami, and Tetsuhisa, Kitamura

Subjects
Adult, Hypernatremia, Japan, Sodium, Humans, Registries, Prognosis, Cardiopulmonary Resuscitation, Out-of-Hospital Cardiac Arrest, Hyponatremia
Abstract

Dysnatremia is an electrolytic disorder commonly associated with mortality in various diseases. However, little is known about dysnatremia in out-of-hospital cardiac arrest (OHCA) cases. Here, we investigated the association between serum sodium level on hospital arrival and neurological outcomes after OHCA. This nationwide hospital-based observational study (The Japanese Association for Acute Medicine Out-of-Hospital Cardiac Arrest registry) enrolled patients with OHCA between 2014 and 2017. We included adult patients aged ≥ 18 years with non-traumatic OHCA who achieved return of spontaneous circulation (ROSC) and whose serum sodium level on hospital arrival was available. Based on the serum sodium level, patients were divided into three levels: hyponatremia (Na 135 mEq/L), normal sodium level (Na ≥ 135 or ≤ 145 mEq/L), and hypernatremia (Na 145 mEq/L). The primary outcome was 1-month survival with favourable neurological outcomes. Altogether, 34 754 patients with OHCA were documented, and 5160 patients with non-traumatic OHCA and who achieved ROSC were eligible for our analyses. The proportion of favourable neurological outcomes was highest in patients with normal sodium levels at 17.6% (677/3854), followed by patients with hyponatremia at 8.2% (57/696) and patients with hypernatremia at 5.7% (35/610). Moreover, hyponatremia and hypernatremia were associated with a decreased probability of favourable neurological outcomes compared with normal sodium level (vs. hyponatremia, adjusted odds ratio [AOR] 0.97, 95% confidence interval [CI] 0.95-0.99; vs. hypernatremia, AOR 0.96, 95% CI 0.94-0.98). Hypo- and hypernatremia on hospital arrival were associated with a decreased probability of favourable neurological outcomes in patients with non-traumatic OHCA who achieved ROSC.

Published
2021

7. Impact of Low-Flow Duration on Favorable Neurological Outcomes of Extracorporeal Cardiopulmonary Resuscitation After Out-of-Hospital Cardiac Arrest: A Multicenter Prospective Study

Author

Koichi Hayakawa, Kazuhisa Yoshiya, Masafumi Kishimoto, Tetsuro Nishimura, Tetsuhisa Kitamura, Yohei Okada, Takuya Ishibe, Bon Ohta, Taro Irisawa, Yoshiki Yagi, Haruko Sakamoto, Norihiro Nishioka, Taku Sogabe, Tomoki Yamada, Tasuku Matsuyama, Keitaro Suzuki, Kazuo Noguchi, Takeshi Shimazu, Fumiko Nakamura, Yasuyuki Hayashi, Takeyuki Kiguchi, Taku Iwami, Hiroshi Shintani, Satoshi Matsui, Takaya Morooka, and Junya Sado

Subjects
Male, business.industry, medicine.medical_treatment, Out of hospital cardiac arrest, Flow duration curve, Cardiopulmonary Resuscitation, Extracorporeal Membrane Oxygenation, Treatment Outcome, Physiology (medical), Anesthesia, medicine, Humans, Extracorporeal cardiopulmonary resuscitation, Female, Cardiopulmonary resuscitation, Prospective Studies, Cardiology and Cardiovascular Medicine, Prospective cohort study, business, Out-of-Hospital Cardiac Arrest
Published
2020

8. Development and Validation of a Clinical Score to Predict Neurological Outcomes in Patients With Out-of-Hospital Cardiac Arrest Treated With Extracorporeal Cardiopulmonary Resuscitation

Author

Haruko Sakamoto, Tomoki Yamada, Takeshi Shimazu, Yoshiki Yagi, Fumiko Nakamura, Tetsuro Nishimura, Toshiya Inoue, Yohei Okada, Takeyuki Kiguchi, Yasuyuki Hayashi, Norihiro Nishioka, Satoshi Yoshimura, Taku Sogabe, Shigeru Ohtsuru, Daisuke Kobayashi, Satoshi Matsui, Masafumi Kishimoto, Takuya Ishibe, Takaya Morooka, Taku Iwami, Tetsuhisa Kitamura, Taro Irisawa, Atsushi Hirayama, Tasuku Matsuyama, Kazuhisa Yoshiya, Keitaro Suzuki, Changhwi Park, and Shunsuke Kimata

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, MEDLINE, Logistic regression, Risk Assessment, Time-to-Treatment, Random Allocation, Extracorporeal Membrane Oxygenation, Japan, Interquartile range, Internal medicine, medicine, Humans, Extracorporeal cardiopulmonary resuscitation, In patient, Registries, Cardiopulmonary resuscitation, Aged, Retrospective Studies, Original Investigation, business.industry, Research, Reproducibility of Results, General Medicine, Middle Aged, Cardiopulmonary Resuscitation, Online Only, Cohort, Emergency Medicine, Female, business, Out-of-Hospital Cardiac Arrest, Cohort study
Abstract

Key Points Question Can the neurological outcome of patients with out-of-hospital cardiac arrest and shockable rhythm who are treated with extracorporeal cardiopulmonary resuscitation (ECPR) be predicted using accessible information? Findings In this prognostic study of 916 patients, a model using time to hospital arrival, pH in initial blood gas assessment, shockable rhythm on hospital arrival, and being younger than 65 years was developed to predict survival with good neurological outcome. The model had good performance and was well calibrated. Meaning These findings suggest that this model may be useful for predicting the neurological outcomes of patients with out-of-hospital cardiac arrest and shockable rhythm treated with ECPR., This prognostic study develops and validates a prediction model for neurological outcomes of patients with out-of-hospital cardiac arrest with shockable rhythm treated with extracorporeal cardiopulmonary resuscitation., Importance Extracorporeal cardiopulmonary resuscitation (ECPR) is expected to improve the neurological outcomes of patients with refractory cardiac arrest; however, it is invasive, expensive, and requires substantial human resources. The ability to predict neurological outcomes would assist in patient selection for ECPR. Objective To develop and validate a prediction model for neurological outcomes of patients with out-of-hospital cardiac arrest with shockable rhythm treated with ECPR. Design, Setting, and Participants This prognostic study analyzed data from the Japanese Association for Acute Medicine Out-of-Hospital Cardiac Arrest registry, a multi-institutional nationwide cohort study that included 87 emergency departments in Japan. All adult patients with out-of-hospital cardiac arrest and shockable rhythm who were treated with ECPR between June 2014 and December 2017 were included. Patients were randomly assigned to the development and validation cohorts based on the institutions. The analysis was conducted between November 2019 and August 2020. Exposures Age (

Published
2020

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