Observational studyCritical care (London, England)2023
Outcome assessment for out-of-hospital cardiac arrest patients in Singapore and Japan with initial shockable rhythm.
Observational study in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 11 citations in OpenAlex.
- Comparison of video-assisted CPR using the LINE application and telephone-assisted CPR: a randomized controlled simulation trial.BMC emergency medicine · 2026Trial
- Association between destination hospital level and outcomes in out-of-hospital cardiac arrest patients under a dispatch-guided transport system: a population-based study in Nagoya, Japan.Resuscitation plus · 2026Article
- Cerebral Oxygen Saturation Responsiveness During Cardiopulmonary Resuscitation After Prolonged Ventricular Fibrillation: A Porcine Study.Journal of clinical medicine · 2026Article
- Wolf Creek XVIII Part 7: strategies to optimize international collaborations in cardiac arrest research.Resuscitation plus · 2026Article
- Leveraging AI and transfer learning to enhance out-of-hospital cardiac arrest outcome prediction in diverse setting.NPJ digital medicine · 2025Article
- Sex differences in extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: nationwide multicenter retrospective study in Japan.Critical care (London, England) · 2024Article
- Machine learning prediction of refractory ventricular fibrillation in out-of-hospital cardiac arrest using features available to EMS.Resuscitation plus · 2024Article
- Comparing outcomes of out-of-hospital cardiac arrest patients with initial shockable rhythm in Singapore and Osaka using population-based databases.Critical care (London, England) · 2023Article
- Explainable artificial intelligence in emergency medicine: an overview.Clinical and experimental emergency medicine · 2023Article
Corrections and comments
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Authors and funding
19 authors at 14 institutions in 2 countries.
Funding
Abstract
backgroundSingapore 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.
methodsThis 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).
resultsFrom 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]).
conclusionThis 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.
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