Abstract 10902: The Association of Public-Access Defibrillation Rate With Mortality and Neurological Outcomes in Out-of-Hospital Cardiac Arrest Patients With Bystander-Witnessed and Initial Shockable Rhythm During Covid-19 Pandemic in Japan

Abstract

Introduction: On January 16, 2020, the first COVID-19 infectious patient was reported in Japan. Since then, we have faced on the unprecedented COVID-19 pandemic. Initially, the direct mortality caused by COVID-19 had been focused on. However, recently, the pandemic’s indirect negative effects, stagnation of chain of survival, has been seen as a problem. Hypothesis: The negative impact would be particularly large on out-of-hospital cardiac arrest (OHCA) patients with initial shockable rhythm. Methods: This is a retrospective cohort study from the All-Japan Utstein Registry, which is a population-based and nationwide registry. Primary outcome are survival rate and favorable neurological outcome (Cerebral Performance Category of 1 or 2) at 30 days. We identified the association of the use of AED with survival and neurological outcome in patients who had OHCA events, bystander-witnessed and initial shockable rhythm before and after COVID-19 pandemic. Results: We compared the 5,240 OHCA patients with bystander-witnessed and initial shockable rhythm in pandemic period (2020) to the 16,628 of those in non-pandemic period (2017-19). The use of AED was decreased, (22.5 vs 20.3 %, respectively, p<0.001) and the survival rate and the proportion of favorable neurological outcome at 30 days was decreased. (39.3 vs 37.7 %, respectively, p=0.04; 28.7 vs 26.1 %, respectively, p<0.001) In addition, we compared by the regions. In regions of infection spread, the use of AED was decreased (25.9 vs 22.5 %, respectively, p=0.001), and the survival rate and the proportion of favorable neurological outcome at 30 days was decreased. (40.8 vs 36.8%, respectively, p<0.001; 29.5 vs 24.5 %, respectively, p<0.001) However, in regions of infection non-spread, there are no significantly differences in these points. Conclusion: The delay of prehospital intervention may have negatively effected in the survival rate and favorable neurological outcome at 30 days during COVID-19 pandemic.