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Clinical paper| Volume 164, P46-53, July 2021

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The interplay between bystander cardiopulmonary resuscitation and ambient temperature on neurological outcome after cardiac arrest: A nationwide observational cohort study

  • Kei Hayashida
    Correspondence
    Corresponding author at: 350 Community Drive, Manhasset, NY 11030, USA.
    Affiliations
    Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA

    Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA

    Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
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  • Ryosuke Takegawa
    Affiliations
    Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA

    Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA
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  • Mitsuaki Nishikimi
    Affiliations
    Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA

    Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA
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  • Tomoaki Aoki
    Affiliations
    Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA

    Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA
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  • Ryo Emoto
    Affiliations
    Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan
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  • Koichiro Shinozaki
    Affiliations
    Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA

    Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA

    Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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  • Santiago J. Miyara
    Affiliations
    Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA

    Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA

    Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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  • Daniel M. Rolston
    Affiliations
    Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA

    Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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  • Timmy Li
    Affiliations
    Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA

    Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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  • Muhammad Shoaib
    Affiliations
    Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA

    Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA

    Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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  • Tatsuma Fukuda
    Affiliations
    Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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  • Ernesto P. Molmenti
    Affiliations
    Department of Surgery, Medicine, and Pediatrics, Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA

    Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
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  • Masaru Suzuki
    Affiliations
    Department of Emergency Medicine, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
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  • Junichi Sasaki
    Affiliations
    Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
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  • Shigeyuki Matsui
    Affiliations
    Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan
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  • Lance B. Becker
    Affiliations
    Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA

    Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA

    Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA

    Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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      Abstract

      Background

      At lower ambient temperature, patients with out-of-hospital cardiac arrest (OHCA) easily experience hypothermia. Hypothermia has shown to improve the rate of successful return of spontaneous circulation (ROSC) in animal models. We hypothesized that lower temperature affects the impact of bystander cardiopulmonary resuscitation (CPR) on the increased odds of a favorable neurological outcome post-OHCA.

      Methods

      This study used information collected by the prospective, nationwide, Utstein registry to examine data from 352,689 adult patients who experienced OHCA from 2012 to 2016 in Japan. The primary outcome was a 1-month favorable neurological outcomes. Multivariable logistic regression analyses were conducted to test the impact of bystander CPR according to the temperature on the favorable outcome.

      Results

      A total of 201,111 patients with OHCA were included in the complete case analysis. The lower temperature group had lower proportions of receiving bystander CPR (46.5 vs. 47.9%) and having favorable outcome (2.1 vs 2.8%) than those in the higher group. Multivariable analysis revealed that bystander CPR at lower temperatures was significantly associated with favorable outcomes (adjusted odds ratio, 1.22; 95% CI, 1.09–1.37), whereas bystander CPR at higher temperatures was not associated with favorable outcomes (1.02; 0.92–1.13). The nonlinear relationship using a spline curve in the multivariable model revealed that odds ratio of favorable neurological outcomes associated with bystander CPR increased as the temperature decreased.

      Conclusion

      Bystander CPR was associated with favorable neurological outcomes at lower temperatures. The odds of a favorable outcome associated with bystander CPR increased as the temperature decreased.

      Keywords

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      References

        • Go A.S.
        • Mozaffarian D.
        • Roger V.L.
        • et al.
        Heart disease and stroke statistics—2014 update: a report from the American Heart Association.
        Circulation. 2014; 129: e28-e292
        • Organization WH
        WHO housing and health guidelines.
        2018 (Accessed 27 August 2020, at https://appswhoint/iris/bitstream/handle/10665/276001/9789241550376-engpdf)
        • Bagai A.
        • McNally B.F.
        • Al-Khatib S.M.
        • et al.
        Temporal differences in out-of-hospital cardiac arrest incidence and survival.
        Circulation. 2013; 128: 2595-2602
        • Fukuda T.
        • Ohashi N.
        • Doi K.
        • et al.
        Impact of seasonal temperature environment on the neurologic prognosis of out-of-hospital cardiac arrest: a nationwide, population-based cohort study.
        J Crit Care. 2014; 29: 840-847
        • Cho E.J.
        • Shin S.D.
        • Jeong S.
        • Kwak Y.H.
        • Suh G.J.
        The effect of atmosphere temperature on out-of-hospital cardiac arrest outcomes.
        Resuscitation. 2016; 109: 64-70
        • Stratil P.
        • Wallmueller C.
        • Schober A.
        • et al.
        Seasonal variability and influence of outdoor temperature on body temperature of cardiac arrest victims.
        Resuscitation. 2013; 84: 630-634
        • Benz-Woerner J.
        • Delodder F.
        • Benz R.
        • et al.
        Body temperature regulation and outcome after cardiac arrest and therapeutic hypothermia.
        Resuscitation. 2012; 83: 338-342
        • Boddicker K.A.
        • Zhang Y.
        • Zimmerman M.B.
        • Davies L.R.
        • Kerber R.E.
        Hypothermia improves defibrillation success and resuscitation outcomes from ventricular fibrillation.
        Circulation. 2005; 111: 3195-3201
        • Menegazzi J.J.
        • Rittenberger J.C.
        • Suffoletto B.P.
        • et al.
        Effects of pre-arrest and intra-arrest hypothermia on ventricular fibrillation and resuscitation.
        Resuscitation. 2009; 80: 126-132
        • Kitamura T.
        • Iwami T.
        • Kawamura T.
        • Nagao K.
        • Tanaka H.
        • Hiraide A.
        Implementation working group for the all-Japan Utstein Registry of the F and disaster management A. Nationwide public-access defibrillation in Japan.
        N Engl J Med. 2010; 362: 994-1004
        • Jacobs I.
        • Nadkarni V.
        • Bahr J.
        • et al.
        Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Councils of Southern Africa).
        Circulation. 2004; 110: 3385-3397
        • Perkins G.D.
        • Jacobs I.G.
        • Nadkarni V.M.
        • et al.
        Cardiac arrest and cardiopulmonary resuscitation outcome reports: update of the Utstein Resuscitation Registry templates for out-of-hospital cardiac arrest: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia); and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation.
        Circulation. 2015; 132: 1286-1300
        • Nagao K.
        • Nonogi H.
        • Yonemoto N.
        • et al.
        Duration of prehospital resuscitation efforts after out-of-hospital cardiac arrest.
        Circulation. 2016; 133: 1386-1396
      1. Fire and Disaster Management Agency of the Ministry of Internal Affairs and Communications. Fire white paper [in Japanese]. (Accessed 27 August 2020), at https://www.fdma.go.jp/publication/hakusho/h29/assets_c/2019/02/shiryo2-1-2hyo_01-8439.html).

        • Kitamura T.
        • Iwami T.
        • Kawamura T.
        • et al.
        Nationwide improvements in survival from out-of-hospital cardiac arrest in Japan.
        Circulation. 2012; 126: 2834-2843
        • Okabayashi S.
        • Matsuyama T.
        • Kitamura T.
        • et al.
        Outcomes of patients 65 years or older after out-of-hospital cardiac arrest based on location of cardiac arrest in Japan.
        JAMA Netw Open. 2019; 2e191011
        • Statistics Bureau Ministry of Internal Affairs and Communications Japan
        Population census of Japan 2015.
        2016 (Accessed 27 August 2020, at http://www.stat.go.jp/english/info/news/20160420.html)
      2. Japan Meteorological Agency. Japanese National Meteorology Database. (Accessed 27 August 2020, at http://www.data.jma.go.jp/gmd/risk/obsdl/index.php).

        • Cummins R.O.
        • Chamberlain D.A.
        • Abramson N.S.
        • et al.
        Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the Utstein Style. A statement for health professionals from a task force of the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, and the Australian Resuscitation Council.
        Circulation. 1991; 84: 960-975
        • Cummins R.O.
        • Ornato J.P.
        • Thies W.H.
        • Pepe P.E.
        Improving survival from sudden cardiac arrest: the "chain of survival" concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association.
        Circulation. 1991; 83: 1832-1847
        • Jacobs I.
        • Nadkarni V.
        • Bahr J.
        • et al.
        Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries. A statement for healthcare professionals from a task force of the international liaison committee on resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa).
        Resuscitation. 2004; 63: 233-249
        • Thornes J.E.
        • Fisher P.A.
        • Rayment-Bishop T.
        • Smith C.
        Ambulance call-outs and response times in Birmingham and the impact of extreme weather and climate change.
        Emerg Med J. 2014; 31: 220-228
        • Iwami T.
        • Hiraide A.
        • Nakanishi N.
        • et al.
        Outcome and characteristics of out-of-hospital cardiac arrest according to location of arrest: a report from a large-scale, population-based study in Osaka, Japan.
        Resuscitation. 2006; 69: 221-228
        • Kranc H.
        • Novack V.
        • Shtein A.
        • Sherman R.
        • Novack L.
        Extreme temperature and out-of-hospital-cardiac-arrest. Nationwide study in a hot climate country.
        Environ Health. 2021; 20: 38
        • Shen Y.
        • Zhang X.
        • Chen C.
        • et al.
        The relationship between ambient temperature and acute respiratory and cardiovascular diseases in Shenyang, China.
        Environ Sci Pollut Res Int. 2021;
        • Lian H.
        • Ruan Y.
        • Liang R.
        • Liu X.
        • Fan Z.
        Short-term effect of ambient temperature and the risk of stroke: a systematic review and meta-analysis.
        Int J Environ Res Public Health. 2015; 12: 9068-9088
        • Polderman K.H.
        Mechanisms of action, physiological effects, and complications of hypothermia.
        Crit Care Med. 2009; 37: S186-202
        • Riter H.G.
        • Brooks L.A.
        • Pretorius A.M.
        • Ackermann L.W.
        • Kerber R.E.
        Intra-arrest hypothermia: both cold liquid ventilation with perfluorocarbons and cold intravenous saline rapidly achieve hypothermia, but only cold liquid ventilation improves resumption of spontaneous circulation.
        Resuscitation. 2009; 80: 561-566
        • Mustafa S.
        • Thulesius O.
        Cooling-induced carotid artery dilatation: an experimental study in isolated vessels.
        Stroke. 2002; 33: 256-260
        • Yu H.
        • Wang L.
        • Zhang H.
        • et al.
        Effect of mild hypothermia on cerebral microcirculation in a murine cardiopulmonary resuscitation model.
        Microcirculation. 2019; 26e12537