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Association between emergency medical service transport time and survival in patients with traumatic cardiac arrest: a Nationwide retrospective observational study

Hiromichi Naito, Tetsuya Yumoto, Takashi Yorifuji, Tsuyoshi Nojima, Hirotsugu Yamamoto, Taihei Yamada, Kohei Tsukahara, Mototaka Inaba, Takeshi Nishimura, Takenori Uehara, Atsunori Nakao

BMC Emergency Medicine 21 ( 1 ) 2021年12月

掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media LLC

<title>Abstract</title><sec>
<title>Background</title>
Patients with traumatic cardiac arrest (TCA) are known to have poor prognoses. In 2003, the joint committee of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma proposed stopping unsuccessful cardiopulmonary resuscitation (CPR) sustained for > 15 min after TCA. However, in 2013, a specific time-limit for terminating resuscitation was dropped, due to the lack of conclusive studies or data. We aimed to define the association between emergency medical services transport time and survival to demonstrate the survival curve of TCA.

</sec><sec>
<title>Methods</title>
A retrospective review of the Japan Trauma Data Bank. Inclusion criteria were age ≥ 16, at least one trauma with Abbreviated Injury Scale score (AIS) ≥ 3, and CPR performed in a prehospital setting. Exclusion criteria were burn injury, AIS score of 6 in any region, and missing data. Estimated survival rate and risk ratio for survival were analyzed according to transport time for all patients. Analysis was also performed separately on patients with sustained TCA at arrival.

</sec><sec>
<title>Results</title>
Of 292,027 patients in the database, 5336 were included in the study with 4141 sustained TCA. Their median age was 53 years (interquartile range (IQR) 36–70), and 67.2% were male. Their median Injury Severity Score was 29 (IQR 22–41), and median transport time was 11 min (IQR 6–17). Overall survival after TCA was 4.5%; however, survival of patients with sustained TCA at arrival was only 1.2%. The estimated survival rate and risk ratio for sustained TCA rapidly decreased after 15 min of transport time, with estimated survival falling below 1%.

</sec><sec>
<title>Conclusion</title>
The chances of survival for sustained TCA declined rapidly while the patient is transported with CPR support. Time should be one reasonable factor for considering termination of resuscitation in patients with sustained TCA, although clinical signs of life, and type and severity of trauma should be taken into account clinically.

</sec>

DOI： 10.1186/s12873-021-00499-z

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その他リンク： https://link.springer.com/article/10.1186/s12873-021-00499-z/fulltext.html

The diagnosis of delayed expanding traumatic pseudoaneurysm of thoracic aorta caused by self-inflicted penetrating injury with crossbow bolt: A case report

Shunsuke Nakamura, Taihei Yamada, Hiromichi Naito, Naoya Sakoda, Atsunori Nakao

International Journal of Surgery Case Reports 88 106474 - 106474 2021年11月

水素吸入は高齢者敗血症の予後を改善させるか? 老齢・LPSモデルマウスを用いた検証

青景聡之, 池谷真澄, 藤崎宣友, 大澤郁朗, 内藤宏道, 中尾篤典

日本救急医学会雑誌 32 ( 12 ) 1738 - 1738 2021年11月

蘇生実習における性差教育が与えるインパクト

谷田貴, 折田沙穂, 塚原紘平, 中村俊介, 久保卓也, 小崎吉訓, 野島剛, 内藤宏道, 中尾篤典

日本救急医学会雑誌 32 ( 12 ) 2703 - 2703 2021年11月

A Rare Case of Pelvic Abscess Due to Spontaneous Non-traumatic Bladder Rupture

Kyosuke Inoguchi, Takashi Hongo, Hiromichi Naito, Atsunori Nakao

Cureus 2021年10月

Short or Irregular Sleep Duration in Early Childhood Increases Risk of Injury for Primary School-Age Children: A Nationwide Longitudinal Birth Cohort in Japan. 国際誌

Takafumi Obara, Hiromichi Naito, Kohei Tsukahara, Naomi Matsumoto, Hirotsugu Yamamoto, Takashi Yorifuji, Atsunori Nakao

International journal of environmental research and public health 18 ( 18 ) 2021年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

The aim of this study was to investigate the longitudinal relationship between shorter or irregular sleep duration (SD) in early childhood and increased risk of injury at primary school age using data from a nationwide survey in Japan. We categorized SD into seven groups: 6 h, 7 h, 8 h, 9 hrs, 10 or 11 h, >12 h, and irregular, based on questionnaire responses collected at 5.5 years old. The relationship between SD and incidence of injury at 5.5-nine years of age is shown. In addition, we completed a stratified analysis on children with or without problematic behavior at eight years old. We included 32,044 children, of which 6369 were classified as having an injury and 25,675 as not having an injury. Logistic regression model showed that shorter or irregular SD categories were associated with an increased adjusted odds ratio (aOR) for injuries (6 h: aOR 1.40, 95% confidence interval (CI) 1.19-1.66, 7 h: aOR 1.10, 95% CI, 0.98-1.23, 8 h: aOR 1.13, 95% CI, 1.02-1.26, irregular: aOR 1.26, 95% CI 1.10-1.43). The same tendency was observed with shorter or irregular SD in subgroups with or without behavioral problems. Shorter or irregular sleep habits during early childhood are associated with injury during primary school age.

DOI： 10.3390/ijerph18189512

PubMed

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Emergency Dispatches for Suicide Attempts During the COVID-19 Outbreak in Okayama, Japan: A Descriptive Epidemiological Study.

Hiroshi Habu, Soshi Takao, Ryohei Fujimoto, Hiromichi Naito, Atsunori Nakao, Takashi Yorifuji

Journal of epidemiology 31 ( 9 ) 511 - 517 2021年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Hardships associated with the ongoing coronavirus disease 2019 (COVID-19) pandemic can affect mental health, potentially leading to increased risk of suicide. We examined the relationship between the COVID-19 outbreak and suicide attempts in Okayama, Japan using information from emergency dispatches. METHODS: This was a descriptive epidemiological study. We collected information on emergency dispatches in Okayama City and Kibichuo from March to August in 2018, 2019, and 2020 (n = 47,770 cases). We compared emergency dispatches and their demographic characteristics, especially focusing on suicide attempts, during these 3 years. RESULTS: The number of emergency dispatches in 2020 decreased compared with the previous 2 years, while the number and proportion of emergency dispatches related to suicide attempts increased. This increase was more pronounced among women and those aged 25-49 years. Among women aged 25-49 years, there was a cumulative total of 43 suicide attempts in 2018 and 2019 and 73 suicide attempts in 2020. CONCLUSIONS: The number and proportion of emergency dispatches related to suicide attempts increased in 2020 compared with the previous 2 years, especially among women and those aged 25-49 years. This increase may be partly explained by hardships, such as economic losses or reduced social ties, during the COVID-19 outbreak.

DOI： 10.2188/jea.JE20210066

PubMed

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Hydrogen inhalation protects against acute lung injury induced by hemorrhagic shock and resuscitation

Kohama K, Yamashita H, Aoyama-Ishikawa M, Takahashi T, Billiar TR, Nishimura T, Kotani J, Nakao A*

Surgery 2021年8月

Superior myocardial preservation with HTK solution over Celsior in rat hearts with prolonged cold ischemia

Lee S, Huang CS, Kawamura T, Higemura N, Stolz DB, Billiar TR, Luketich JD, Nakao A, Toyoda Y.

Surgery 2021年8月

Right Hemiplegia Following Acute Carbon Monoxide Poisoning

Kenji Aoshima, Hidenaru Yamaoka, Shunsuke Nakamura, Tsuyoshi Nojima, Hiromichi Naito, Atsunori Nakao

Cureus 2021年7月

Venous thromboembolism in major trauma patients: a single-center retrospective cohort study of the epidemiology and utility of D-dimer for screening. 査読

Yumoto T, Naito H, Yamakawa Y, Iida A, Tsukahara K, Nakao A.

Acute Med Surg 19 ( 4(4) ) 394 - 400 2021年6月

Carbon monoxide poisoning during pregnancy treated with hyperbaric oxygen. 国際誌

Yoshinori Kosaki, Hiroki Maeyama, Tsuyoshi Nojima, Takafumi Obara, Atsunori Nakao, Hiromichi Naito

Clinical case reports 9 ( 5 ) e04138 2021年5月

早期血管内治療を必要とした鋭的外傷による大動脈瘤の一例

中村俊介, 山田太平, 野島剛, 小崎吉訓, 内藤宏道, 中尾篤典

日本外傷学会雑誌 35 ( 2 ) 156 - 156 2021年5月

日本外傷データバンクを用いた研究最前線救急救命士の現場活動関与は外傷患者の転帰を改善するか

西村健, 野島剛, 湯元哲也, 内藤宏道, 中尾篤典, 石原諭, 中山伸一

日本外傷学会雑誌 35 ( 2 ) 131 - 131 2021年5月

Characteristics of self-inflicted injury among suicidal patients: analysis of nation-wide trauma registry

Takeshi Nishimura, Hiromichi Naito, Atsunori Nakao, Shinichi Nakayama

Trauma Surgery & Acute Care Open 6 ( 1 ) e000694 - e000694 2021年4月

掲載種別：研究論文（学術雑誌）出版者・発行元：BMJ

<sec><title>Purpose</title>Self-inflicted injury is one of the most common causes of suicide. Extremity injury is thought to occur most frequently among penetrating injury; however, epidemiology among patients attempting suicide is unknown. This study aims to find the characteristics of penetrating self-inflicted trauma patients.

</sec><sec><title>Methods</title>This is a retrospective cohort study of Japanese nation-wide trauma registry (the Japan National Trauma Data Bank) between January 1, 2004 and December 31, 2017. Patients who attempted suicide with penetrating injury were eligible. We evaluated the occurrence of injury based on injury site (neck/face, chest, abdomen, extremity) as a dependent variable and aging as an independent variable using a generalized linear model and compare those groups with spline models.

</sec><sec><title>Results</title>4576 trauma patients were eligible. Excluding patients with missing age, missing survival data, and missing abbreviate injury score, 4183 patients were enrolled in this study. Common injury site is follows: abdomen 1772 patients (42.4%), extremity 1344 patients (32.0%), neck/face 1253 patients (30.0%), and chest 993 patients (23.7%). The occurrence of neck/face injury, chest injury, and abdominal injury increased with age. On contrary, the rate of extremity injury decreased with age.

</sec><sec><title>Conclusions</title>Among self-inflicted trauma patients, abdominal injury was the most common injury, and neck/face injury, chest injury, and abdominal injury were related with aging. On the contrary, the rate of extremity injury decreased as patients’ age progressed.

</sec><sec><title>Level of evidence</title>Retrospective cohort study, Level III.

</sec>

DOI： 10.1136/tsaco-2021-000694

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Supplementation of parenteral nutrition with fish oil attenuates acute lung injury in a rat model

Kohama K, Nakao A, Terashima M, Aoyama-Ishikawa M, Shimizu T, Harada D, Nakayama M, Yamashita H, Fujiwara M, Kotani J

J Clin Biochem Nutr 2021年3月

The trend of treatment and conveyance system for upper extremity replantation in Japan: A nationwide population-based study from the Japan trauma data bank.

Taichi Saito, Satoshi Nezu, Minami Matsuhashi, Ryuichi Nakahara, Yasunori Shimamura, Tomoyuki Noda, Tetsuya Yumoto, Atsunori Nakao, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 26 ( 2 ) 271 - 275 2021年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: In Japan, microsurgical skill development and a system to transfer patients to an appropriate hospital for upper extremity amputation have been promoted; however, information about trends of replantation is limited. Therefore, the aim of this study was to clarify the trends in the treatment for upper extremity amputation using the Japan Trauma Data Bank (JTDB). METHODS: Data derived from JTDB (2004-2015) were used to quantify trends in the volume of replantation for upper extremity amputation including finger amputation. Trauma was diagnosed based on the Abbreviated Injury Scale code; a subgroup of patients who underwent replantation was delineated. We investigated patient demographics, infection rate, and characteristics of treating facilities. RESULTS: A total of 1240 patients underwent upper extremity amputation. Among these, 510 (41.1%) underwent replantation, and the rate of replantation did not change over the study period. The average age of patients who underwent or did not undergo replantation was 45.5 and 47.2 years, respectively. The proportion of the patients who were transferred to another hospital for treatment significantly decreased between 2004 (28.5%) and 2015 (16.3%) (P < 0.01). Time taken for transfer from the accident site to hospitals increased. The rate of patients who underwent replantation differed among different hospitals; however, higher-volume hospitals were more likely to perform replantation. CONCLUSION: The rate of patients transferred to another hospital decreased between 2004 and 2015; however, the rate of patients who underwent replantation remained unchanged. This suggests that the number of patients who were transported directly from the accident site to an appropriate hospital has increased, whereas the indication for care in each hospital remains unchanged. Common criteria for amputations are needed to address the differing rates of replantation among hospitals.

DOI： 10.1016/j.jos.2020.03.006

PubMed

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災害教育とインストラクショナルデザイン〜課題解決型人材育成災害対応する薬剤師に求められる要素とその教育方法

渡邉暁洋, 中尾博之, 山田太平, 中尾篤典

Japanese Journal of Disaster Medicine 25 ( 3 ) 136 - 136 2021年3月

災害教育とインストラクショナルデザイン～課題解決型人材育成災害対応する薬剤師に求められる要素とその教育方法

渡邉暁洋, 中尾博之, 山田太平, 中尾篤典

Japanese Journal of Disaster Medicine 25 ( 3 ) 136 - 136 2021年3月

マムシ抗毒素投与が奏功した血小板減少型マムシ咬傷の1例

岡本彩, 向笠廣太, 小原隆史, 野島剛, 中尾篤典, 鬼塚拡平, 浦部尚吾, 井上智博, 古賀仁士, 山下寿

佐賀救急医学会雑誌 7 ( 1 ) 11 - 14 2021年3月

記述言語：日本語出版者・発行元：佐賀救急医学会

74歳男性。農作業中に右示指をマムシに咬まれ意識消失し、受傷30分後に当院へ搬送となった。所見では意識清明で、右示指に滲出性出血を伴う創があった。出血持続、全身紫斑、血小板減少を認めたことから、マムシ毒による血小板減少と診断され、受傷5時間後にマムシ抗毒素を投与した。その結果、血小板数や症状は速やかに改善し、第15病日に退院となった。

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