TY - JOUR
T1 - The effects of bystander interventions for foreign body airway obstruction on survival and neurological outcomes
T2 - Findings of the MOCHI registry
AU - Norii, Tatsuya
AU - Igarashi, Yutaka
AU - Yoshino, Yudai
AU - Nakao, Shunichiro
AU - Yang, Ming An
AU - Albright, Danielle
AU - Sklar, David P.
AU - Crandall, Cameron
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/6
Y1 - 2024/6
N2 - Introduction: Foreign body airway obstruction (FBAO) is a life-threatening condition. We aimed to quantify the impact of bystander FBAO interventions on survival and neurological outcomes. Methods: We conducted a Japan-wide prospective, multi-center, observational study including all FBAO patients who presented to the Emergency Department from April 2020 to March 2023. Information on bystander FBAO interventions was collected through interviews with emergency medical services personnel. Primary outcomes included 1-month survival and favorable neurologic outcome defined as Cerebral Performance Category 1 or 2. We performed a multivariable logistic regression and a Cox proportional hazards modeling to adjust for confounders. Results: We analyzed a total of 407 patients in the registry who had the median age of 82 years old (IQR 73–88). The FBAO incidents were often witnessed (86.5%, n = 352/407) and the witnesses intervened in just over half of the cases (54.5%, n = 192/352). The incidents frequently occurred at home (54.3%, n = 221/407) and nursing home (21.6%, n = 88/407). Common first interventions included suction (24.8%, n = 101/407) and back blow (20.9%, n = 85/407). The overall success rate of bystander interventions was 48.4% (n = 93/192). About half (48.2%, n = 196/407) survived to 1-month and 23.8% patients (n = 97/407) had a favorable neurological outcome. Adjusting for pre-specified confounders, bystander interventions were independently associated with survival (hazard ratio, 0.55; 95% CI, 0.39–0.77) and a favorable neurological outcome (adjusted OR, 2.18; 95% CI, 1.23–3.95). Conclusion: Bystander interventions were independently associated with survival and favorable neurological outcome, however, they were performed only in the half of patients.
AB - Introduction: Foreign body airway obstruction (FBAO) is a life-threatening condition. We aimed to quantify the impact of bystander FBAO interventions on survival and neurological outcomes. Methods: We conducted a Japan-wide prospective, multi-center, observational study including all FBAO patients who presented to the Emergency Department from April 2020 to March 2023. Information on bystander FBAO interventions was collected through interviews with emergency medical services personnel. Primary outcomes included 1-month survival and favorable neurologic outcome defined as Cerebral Performance Category 1 or 2. We performed a multivariable logistic regression and a Cox proportional hazards modeling to adjust for confounders. Results: We analyzed a total of 407 patients in the registry who had the median age of 82 years old (IQR 73–88). The FBAO incidents were often witnessed (86.5%, n = 352/407) and the witnesses intervened in just over half of the cases (54.5%, n = 192/352). The incidents frequently occurred at home (54.3%, n = 221/407) and nursing home (21.6%, n = 88/407). Common first interventions included suction (24.8%, n = 101/407) and back blow (20.9%, n = 85/407). The overall success rate of bystander interventions was 48.4% (n = 93/192). About half (48.2%, n = 196/407) survived to 1-month and 23.8% patients (n = 97/407) had a favorable neurological outcome. Adjusting for pre-specified confounders, bystander interventions were independently associated with survival (hazard ratio, 0.55; 95% CI, 0.39–0.77) and a favorable neurological outcome (adjusted OR, 2.18; 95% CI, 1.23–3.95). Conclusion: Bystander interventions were independently associated with survival and favorable neurological outcome, however, they were performed only in the half of patients.
KW - Airway management
KW - Cardiac Arrest
KW - Foreign body airway obstruction
KW - Resuscitation
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U2 - 10.1016/j.resuscitation.2024.110198
DO - 10.1016/j.resuscitation.2024.110198
M3 - Article
C2 - 38582443
AN - SCOPUS:85190758400
SN - 0300-9572
VL - 199
JO - Resuscitation
JF - Resuscitation
M1 - 110198
ER -