ArticleAcute medicine & surgery
Difficult-to-transport cases and neurological outcomes of out-of-hospital cardiac arrest: A population-based nationwide study in Japan.
Article in Acute medicine & surgery. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Potential return of spontaneous circulation in Japanese out-of-hospital cardiac arrest patients with pseudo-pulseless electrical activity: a post hoc analysis of a prospective multicentric study.Resuscitation plus · 2026Article
- Difficult-to-transport cases and neurological outcomes of out-of-hospital cardiac arrest: A population-based nationwide study in Japan.Acute medicine & surgeryArticle
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Authors and funding
4 authors.
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Abstract
Aim: In Japan, emergency medical service personnel often have difficulty obtaining hospitals' acceptance of emergency cases owing to congestion in the emergency unit; such cases are called difficult-to-transport cases. Increased difficult-to-transport cases at a regional level may be associated with the prognosis of out-of-hospital cardiac arrest (OHCA). This study aimed to investigate the association between the proportion of difficult-to-transport cases at a regional level and neurological outcomes in patients with OHCA, using the nationwide Utstein database linked to ambulance records in Japan. Methods: In this retrospective cohort study from 2017 to 2021 in Japan, the proportion of difficult-to-transport cases was calculated as the number of difficult-to-transport cases divided by the number of emergency calls in each district on each day. Patients with OHCA were categorized into no, low, and high difficult-to-transport cases groups. The primary outcome was a Cerebral Performance Category 1 or 2 at 1 month. The secondary outcome was transportation time intervals. Multivariate regression analyses were conducted to assess the association between difficult-to-transport cases and patient outcomes. Results: Among 592,021 eligible patients, the no, low, and high difficult-to-transport case groups included 282,747 (48%), 155,167 (26%), and 154,107 (26%) patients, respectively. The high difficult-to-transport cases group was associated with decreased favorable neurological outcomes (adjusted odds ratio, 0.91; 95% confidence interval, 0.86-0.95) and longer total transportation time (difference, 4.1 min; 95% confidence interval, 3.8-4.4). Conclusion: A higher proportion of difficult-to-transport cases was associated with poorer neurological outcomes and longer total transportation times in patients with OHCA.
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