Fig. 1.
Fig. 2.
Outcomes distribution in each sub-phenotype
| Overall (n=2,162) | Sub-phenotypes | p value | ||||
|---|---|---|---|---|---|---|
| Group 1 (n=528) | Group 2 (n=843) | Group 3 (n=228) | Group 4 (n=563) | |||
| 30-day favorable neurological outcome, n (%) | 526 (24.3) | 284 (53.8) | 179 (21.2) | 26 (11.4) | 37 (6.6) | < .01 |
| 30-day survival, n (%) | 974 (45.1) | 395 (74.8) | 407 (48.3) | 76 (33.3) | 96 (17.1) | < .01 |
Logistic regression analysis for the correlation between sub-phenotypes and outcomes
| Sub-phenotypes | Crude OR | 95% CI (lower) | 95% CI (upper) | p value |
|---|---|---|---|---|
| 30-day favorable neurological outcome | ||||
| Group 1 | 16.5 | 11.4 | 24.1 | < .01 |
| Group 2 | 3.83 | 2.64 | 5.56 | < .01 |
| Group 3 | 1.83 | 1.08 | 3.10 | 0.02 |
| Group 4 | ref | ref | ref | - |
| 30-day survival | ||||
| Group 1 | 14.4 | 10.8 | 19.4 | < .01 |
| Group 2 | 4.54 | 3.51 | 5.88 | < .01 |
| Group 3 | 2.43 | 1.71 | 3.46 | < .01 |
| Group 4 | ref | ref | ref | - |
Demographics and characteristics of analyzed patients with stratified by sub-phenotypes
| Variables | Overall (n=2,162) | Sub-phenotypes | p value | |||
|---|---|---|---|---|---|---|
| Group 1 (n=528) | Group 2 (n=843) | Group 3 (n=228) | Group 4 (n=563) | |||
| Age, years, median (IQR) | 68 (56–77) | 68 (57–77) | 64 (52–74) | 75 (64–83) | 69 (58–80) | < .01 |
| Male, n (%) | 1,553 (71.8) | 389 (73.7) | 649 (77.0) | 138 (70.5) | 377 (67.0) | < .01 |
| Time of emergency call, n (%) | 0.19 | |||||
| 7:00–14:59 | 999 (46.2) | 252 (47.7) | 385 (45.7) | 97 (42.5) | 265 (47.1) | |
| 15:00–22:59 | 758 (35.1) | 195 (36.9) | 290 (34.4) | 77 (33.8) | 196 (34.8) | |
| 23:00–6:59 | 405 (18.7) | 81 (15.3) | 168 (19.9) | 54 (23.7) | 102 (18.1) | |
| Tertiles of prefecture performance rates of out-of-hospital advanced airway management, n (%) | ||||||
| < 37.0 | 521 (24.1) | 114 (21.6) | 204 (24.2) | 63 (27.6) | 140 (24.9) | |
| 37.0–63.6 | 981 (45.4) | 253 (47.9) | 386 (45.8) | 92 (40.4) | 250 (44.4) | 0.53 |
| > 63.6 | 660 (30.5) | 161 (30.5) | 253 (30.0) | 73 (32.0) | 173 (30.7) | |
| Witness status, n (%) | < .01 | |||||
| None | 569 (26.3) | 113 (21.4) | 204 (24.2) | 70 (30.7) | 182 (32.3) | |
| Others | 1327 (61.4) | 369 (69.9) | 552 (65.5) | 121 (53.1) | 285 (50.6) | |
| EMS personnel | 266 (12.3) | 46 (8.7) | 87 (10.3) | 37 (16.2) | 96 (17.1) | |
| Bystander CPR, n (%) | < .01 | |||||
| Absence | 1109 (51.3) | 237 (44.9) | 401 (47.6) | 142 (62.3) | 329 (58.4) | |
| Presence | 795 (36.8) | 227 (43.0) | 331 (39.3) | 68 (29.8) | 169 (30.0) | |
| Presence including rescue breathing | 258 (11.9) | 64 (12.1) | 111 (13.2) | 18 (7.9) | 65 (11.5) | |
| Initial monitored cardiac rhythm, n (%) | < .01 | |||||
| VF | 868 (40.1) | 332 (62.9) | 409 (48.5) | 34 (14.9) | 93 (16.5) | |
| Pulseless VT | 12 (0.6) | 3 (0.6) | 5 (0.6) | 1 (0.4) | 3 (0.5) | |
| PEA | 607 (28.1) | 105 (19.9) | 231 (27.4) | 82 (36.0) | 189 (33.6) | |
| Asystole | 517 (23.9) | 37 (7.0) | 157 (18.6) | 87 (38.2) | 236 (41.9) | |
| Other | 158 (7.3) | 51 (9.7) | 41 (4.9) | 24 (10.5) | 42 (7.5) | |
| Cause of cardiac arrest, n (%) | < .01 | |||||
| Cardiogenic | 1541 (71.3) | 449 (85.0) | 649 (77.0) | 121 (53.1) | 322 (57.2) | |
| Respiratory | 188 (8.7) | 16 (3.0) | 46 (5.5) | 50 (21.9) | 76 (13.5) | |
| Other intrinsic disease | 433 (20.0) | 63 (11.9) | 148 (17.6) | 57 (25.0) | 165 (29.3) | |
| Time from call to I-CPR, min, median (IQR) | 9 (7–11) | 8 (6–10) | 8 (7–11) | 9 (8–11.3) | 9 (8–12) | < .01 |
| Prehospital adrenaline administration, n (%) | 767 (35.5) | 111 (21.0) | 282 (33.5) | 120 (52.6) | 254 (45.1) | < .01 |
| Prehospital shock delivery, n (%) | 1027 (47.5) | 371 (70.3) | 478 (56.7) | 48 (21.1) | 130 (23.1) | < .01 |
| Prehospital AAM, n (%) | 1251 (57.9) | 220 (41.7) | 486 (57.7) | 161 (70.6) | 384 (68.2) | < .01 |
| Physician during emergency transport, n (%) | 1860 (86.0) | 437 (82.8) | 715 (84.8) | 201 (88.2) | 507 (90.1) | 0.01 |
| Time from EMS contact to HA, min, median (IQR) | 23 (18–29) | 23 (17–28) | 21 (16–27) | 27 (21–35) | 25 (19–30) | < .01 |
| Prehospital ROSC, n (%) | 1,009 (46.7) | 379 (81.8) | 340 (40.3) | 115 (50.4) | 175 (31.1) | < .01 |
| GCS on HA, median (IQR) | 3 (3–3) | 3 (3–6) | 3 (3–3) | 3 (3–3) | 3 (3–3) | < .01 |
| pH on HA, median (IQR) | 7.07 (6.90–7.24) | 7.30 (7.25–7.36) | 7.06 (6.95–7.17) | 7.04 (6.93–7.19) | 6.83 (6.73–6.93) | < .01 |
| PaCO2 on HA, mmHg, median (IQR) | 53.3 (38.8–76.9) | 39.1 (33.8–46.3) | 55.6 (40.2–74.0) | 76.9 (59.2–101.6) | 69.1 (49.6–93.1) | < .01 |
| HCO3− on HA, mmol/l, median (IQR) | 15.6 (12.0–19.2) | 19.3 (17.0–21.6) | 14.8 (12.6–17.4) | 21.6 (16.7–25.7) | 10.8 (8.0–13.8) | < .01 |
| BE on HA, median (IQR) | −14.2 (−20.2 –−8.4) | −6.3 (−9.0 –−3.8) | −15.0 (−17.7 –−11.9) | −8.4 (−14.7 –−2.1) | −22.7 (−26.0 –−19.7) | < .01 |
| Lac on HA, mg/dl, median (IQR) | 93.6 (63.0–127.6) | 57.0 (38.0–73.0) | 96.0 (73.8–117.9) | 100.9 (70.4–144.0) | 133.0 (108.9–162.0) | < .01 |
| ECMO, n (%) | 1656 (76.6) | 445 (84.3) | 567 (67.3) | 202 (88.6) | 442 (78.5) | < .01 |
| IABP, n (%) | 1601 (74.1) | 391 (74.1) | 561 (66.5) | 201 (88.2) | 448 (79.6) | < .01 |
| PCI, n (%) | 1610 (74.5) | 343 (65.0) | 587 (69.6) | 205 (89.9) | 475 (84.4) | < .01 |
| TTM, n (%) | 1246 (57.6) | 239 (45.3) | 427 (50.7) | 166 (72.8) | 414 (73.5) | < .01 |
| pH on admission, median (IQR) | 7.30 (7.19–7.37) | 7.37 (7.33–7.42) | 7.30 (7.24–7.37) | 7.33 (7.21–7.41) | 7.11 (6.99–7.20) | < .01 |
| PaO2 on admission, mmHg, median (IQR) | 148.0 (95.0–252.0) | 145.1 (101.0–230.4) | 150.0 (93.6–255.5) | 124.2 (82.8–198.0) | 155.0 (95.8–272.5) | 0.01 |
| PaCO2 on admission, mmHg, median (IQR) | 41.0 (34.4–49.2) | 39.9 (35.3–43.9) | 39.6 (33.1–46.9) | 48.5 (38.7–62.0) | 44.4 (34.1–59.0) | < .01 |
| HCO3− on admission, mmol/l, median (IQR) | 19.6 (15.6–22.9) | 22.4 (20.6–24.2) | 19.3 (16.6–22.1) | 26.0 (20.6–29.4) | 13.9 (10.8–16.6) | < .01 |
| BE on admission, median (IQR) | −6.0 (−11.4 –−2.1) | −2.3 (−4.1 –−0.5) | −6.5 (−9.4 –−3.5) | −0.3 (−5.3 – 4.0) | −15.0 (−18.6 –−11.1) | < .01 |
| Lac on admission, mg/dl, median (IQR) | 48.0 (21.6–84.6) | 21.0 (13.5–32.6) | 45.0 (26.0–68.0) | 52.6 (21.5–115.2) | 95.2 (64.8–130.5) | < .01 |