{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T13:50:40Z","timestamp":1792849840673,"version":"4.5.0"},"reference-count":54,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,11]]},"abstract":"\n Background<\/jats:title>\n \n Mechanical cardiopulmonary resuscitation (\n mCPR<\/jats:styled-content>\n ) for patients with out\u2010of\u2010hospital cardiac arrest attending the emergency department has become more widespread in Japan. The objective of this study is to determine the association between the\n mCPR<\/jats:styled-content>\n in the emergency department and clinical outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n In a prospective, multicenter, observational study, adult patients with out\u2010of\u2010hospital cardiac arrest with sustained circulatory arrest on hospital arrival were identified. The primary outcome was survival to hospital discharge. The secondary outcomes included a return of spontaneous circulation and successful hospital admission. Multivariate analyses adjusted for potential confounders and within\u2010institution clustering effects using a generalized estimation equation\u00a0were used to analyze the association of the\n mCPR<\/jats:styled-content>\n with outcomes. Between January 1, 2012 and March 31, 2013, 6537 patients with out\u2010of\u2010hospital cardiac arrest were eligible; this included 5619 patients (86.0%) in the manual\n CPR<\/jats:styled-content>\n group and 918 patients (14.0%) in the\n mCPR<\/jats:styled-content>\n group. Of those patients, 28.1% (1801\/6419) showed return of spontaneous circulation in the emergency department, 20.4% (1175\/5754) had hospital admission, 2.6% (168\/6504) survived to hospital discharge, and 1.2% (75\/6419) showed a favorable neurological outcome at 1\u00a0month after admission. Multivariate analyses revealed that\n mCPR<\/jats:styled-content>\n was associated with a decreased likelihood of survival to hospital discharge (adjusted odds ratio, 0.40; 95% confidence interval, 0.20\u20130.78;\n P<\/jats:italic>\n =0.005), return of spontaneous circulation (adjusted odds ratio, 0.71; 95% confidence interval, 0.53\u20130.94;\n P<\/jats:italic>\n =0.018), and hospital admission (adjusted odds ratio, 0.57; 95% confidence interval, 0.40\u20130.80;\n P<\/jats:italic>\n =0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n After accounting for potential confounders, the\n mCPR<\/jats:styled-content>\n in the emergency department was associated with decreased likelihoods of good clinical outcomes after adult nontraumatic out\u2010of\u2010hospital cardiac arrest. Further studies are needed to clarify circumstances in which\n mCPR<\/jats:styled-content>\n may benefit these patients.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.007420","type":"journal-article","created":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:10:42Z","timestamp":1509495042000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Mechanical Cardiopulmonary Resuscitation and Hospital Survival Among Adult Patients With Nontraumatic Out\u2010of\u2010Hospital Cardiac Arrest Attending the Emergency Department: A Prospective, Multicenter, Observational Study in Japan (SOS\u2010KANTO [Survey of Survivors after Out\u2010of\u2010Hospital Cardiac Arrest in Kanto Area] 2012 Study)"],"prefix":"10.1161","volume":"6","author":[{"given":"Kei","family":"Hayashida","sequence":"first","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, School of Medicine, Keio University, Tokyo, 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