Regional differences in the incidence of severe brain damage in survivors with cardiac disease and witnessed out-of-hospital cardiac arrest

[Abstract] [Background :] Brain damage can occur after out-of-hospital cardiac arrest (OHCA) leading to permanent disability. [Aims :] This study investigated the incidence of severe brain damage and associated risk factors in survivors with cardiac disease after OHCA. [Methods :] The Utstein database for Japan was used to identify 23,640 survivors with cardiac disease and witnessed OHCA between 2005 and 2012. Survivors were assessed at 1 month. Odds ratios (ORs) for the incidence of severe brain damage according to regional variables were determined with logistic regression analysis. [Results :] The incidence of severe brain damage was 37.3%. Automated external defibrillator use and cardiopulmonary resuscitation were associated with significant improvement in cerebral function ; adrenaline administration and longer duration from request for transport until hospital arrival were associated with deterioration of cerebral function. Twenty of 47 prefectures showed significant ORs for the incidence of severe brain damage. [Conclusion :] Regional differences in the incidence of severe brain damage were found among survivors with cardiac disease and witnessed OHCA.