Dataset Information

Impact of pandemic-related movement restriction on public access defibrillation in Japan: a retrospective cohort study.

ABSTRACT:

Objectives

To analyse monthly changes in public access defibrillation (PAD) incidence and outcomes of out-of-hospital cardiac arrest (OHCA) during the 2020-2021 COVID-19 pandemic compared with those during the 2016-2019 prepandemic period with consideration of pandemic-related movement restriction.

Design

Retrospective cohort study.

Setting

An extended database was created by combining and reconciling the nationwide Utstein-style OHCA and the emergency medical service (EMS) transportation databases in Japan.

Participants

We analysed 226 182 EMS-witnessed, non-newborn and out-of-home OHCA cases in Japan.

Primary and secondary outcome measures

The primary outcomes were the PAD incidence and neurologically favourable 1-month survival rate. The secondary outcomes were bystander cardiopulmonary resuscitation (CPR) provision and dispatcher-assisted CPR attempts.

Results

The proportion of out-of-home OHCA cases slightly decreased during the pandemic (from 33.7% to 31.9%). Although the pandemic was associated with a decreased PAD incidence, 2-year trend analyses by an interaction test showed that the PAD incidence was lower during the first nationwide declaration of a state of emergency (p<0.001) and in the pandemic's second year (p<0.01). Regardless of location, delays in basic life support (BLS) actions and EMS contact with patients were more common and the rate of PAD-induced return of spontaneous circulation was lower during the pandemic. PAD incidence reduction was significant only in locations with a recommendation of automated external defibrillator placement (p<0.001). In other locations, a pronounced delay in BLS was found during the pandemic. The neurologically favourable survival rate was reduced in parallel with the reduced PAD incidence during the pandemic (r=0.612, p=0.002).

Conclusions

Prolonged and repeated movement restrictions during the COVID-19 pandemic worsened the OHCA outcomes concurrently with disturbed BLS actions, including the reduced PAD incidence in out-of-home settings. Maintaining BLS training, re-arranging automated external defibrillator placement and establishing a local alert system for recruiting well-trained citizens to the scene are essential.

SUBMITTER: Omatsu K

PROVIDER: S-EPMC11015190 | biostudies-literature | 2024 Apr

REPOSITORIES: biostudies-literature

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Publications

Impact of pandemic-related movement restriction on public access defibrillation in Japan: a retrospective cohort study.

Omatsu Kentaro K Yamashita Akira A Inaba Hideo H

BMJ open 20240408 4

<h4>Objectives</h4>To analyse monthly changes in public access defibrillation (PAD) incidence and outcomes of out-of-hospital cardiac arrest (OHCA) during the 2020-2021 COVID-19 pandemic compared with those during the 2016-2019 prepandemic period with consideration of pandemic-related movement restriction.<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>An extended database was created by combining and reconciling the nationwide Utstein-style OHCA and the emergency medical service (EMS) ...[more]

PMID: 38589259

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Project description:BackgroundOut-of-hospital cardiac arrest (OHCA) is a global health issue, for which rapid public access defibrillation (PAD) increases survival.ObjectivesThe purpose of this study was to evaluate international legislation relating to PAD and develop legal recommendations to improve PAD in OHCA.MethodsSearches covering 5 domains (automated external defibrillator [AED] provision, funding, identification, maintenance, lay responder training) were conducted in 99 jurisdictions worldwide: United States (50) and Canada (13) analyzed at state/province level; 36 other countries analyzed at national level. Forty-nine legislation sources were searched from September 27, 2021, to May 5, 2022. Legislative data were classified: Enabling Legislation (facilitating PAD) or Disabling Legislation (hindering PAD). Based on retrieved data, recommendations for international AED laws were developed.ResultsSearches identified 419,248 legal records. Enabling Legislation regarding AED provision in public areas was present in 60% U.S. states, 8% Canadian provinces, and 22% of nations studied from the rest of world. Disabling Legislation regarding registration of AEDs, that could potentially discourage AED ownership, was found in 37 North American jurisdictions. Enabling Legislation regarding AED signage was found in 66% U.S. states and 39% of all jurisdictions worldwide. Overall, 48% of worldwide jurisdictions studied had legislative requirements for AED maintenance, including 80% of all U.S. states. Internationally, 49.5% of jurisdictions studied had Enabling Legislation mandating AED training, and 66% United States had this for schools. Only 4 jurisdictions worldwide gave implicit authorization to laypersons for AED use in emergencies.ConclusionsThere is significant variability in international legislation relating to PAD. All countries should consider Enabling Legislation that could decrease delays to PAD. Similarly, Disabling Legislation potentially hindering prompt PAD during OHCA should be withdrawn.

Project description:ObjectivesWe aimed to investigate the impact of the first and second waves of the COVID-19 pandemic on healthcare service use by non-COVID-19 patients.DesignRetrospective cohort study.SettingHospital-based claims database from anonymised hospitals in Japan.ParticipantsPatients (n=785 495) who visited and/or were hospitalised in 26 anonymised hospitals in Japan between January 2017 and November 2020.Outcome measuresWe compared changes in the monthly number of hospitalisations (overall or by diagnosis), outpatient visits, endoscopic fibrescopies (EFs), rehabilitations, outpatient chemotherapy treatments, maintenance haemodialysis treatments and outpatient prescriptions between pre-COVID-19 years and the same period in 2020.ResultsThe overall number of hospitalisations and outpatient visits decreased by 27% and 22%, respectively, in May 2020, of which the most substantial decrease was observed in the paediatrics department (65% and 51%, respectively). The number of hospitalisations for respiratory diseases, circulatory diseases, malignant neoplasms and digestive diseases decreased by a maximum of 55%, 32%, 10% and 26%, respectively, in 2020. The number of hospitalisations for non-COVID-19 pneumonia in patients aged <16 years, patients aged ≥16 years and patients with asthma decreased by 93%, 43% and 80%, respectively, in May 2020. EFs and outpatient rehabilitations decreased by >30%. In contrast, outpatient chemotherapy and maintenance haemodialysis treatments decreased by <10%, if at all. Outpatient prescriptions decreased by a maximum of 20% in 2020, with the largest decrease observed in drugs for obstructive airway diseases and cough and cold preparations.ConclusionsThe use of healthcare services by non-COVID-19 patients was most affected during the first wave of the COVID-19 pandemic in May 2020. The number of hospitalisations for respiratory diseases, particularly non-COVID-19 pneumonia and asthma, drastically decreased, while the number of hospitalisations and outpatient chemotherapies for malignant neoplasms or maintenance haemodialysis was less affected.

Dataset Information

Impact of pandemic-related movement restriction on public access defibrillation in Japan: a retrospective cohort study.

Objectives

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

Impact of pandemic-related movement restriction on public access defibrillation in Japan: a retrospective cohort study.

Similar Datasets

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