Hydrocortisone administration was associated with improved survival in Japanese patients with cardiac arrest

Takahiro Niimura, Yoshito Zamami, Toshihiro Koyama, Yuki Izawa-Ishizawa, Masashi Miyake, Tadashi Koga, Keisaku Harada, Ayako Ohshima, Toru Imai, Yutaka Kondo, Masaki Imanishi, Kenshi Takechi, Keijo Fukushima, Yuya Horinouchi, Yasumasa Ikeda, Hiromichi Fujino, Koichiro Tsuchiya, Toshiaki Tamaki, Shiro Hinotsu, Mitsunobu R. KanoKeisuke Ishizawa

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Abstract

There are few reports on hydrocortisone administration after cardiac arrest, and those that have been published included few subjects. This study aimed to evaluate the effect of hydrocortisone administration on the outcomes of patients who experienced cardiac arrest. We investigated the survival discharge rates and the length of hospital stay from cardiac arrest to discharge, stratified by use of hydrocortisone, using a Japanese health-insurance claims dataset that covers approximately 2% of the Japanese population. The study included the data of 2233 subjects who experienced either in-hospital or out-of-hospital cardiac arrest between January 2005 and May 2014. These patients were divided into two groups, based on the administration of hydrocortisone. We adjusted the baseline characteristics, medical treatment, and drug administration data of the two groups using propensity scores obtained via the inverse probability of treatment weighted method. The hydrocortisone group had a significantly higher survival discharge rate (13/61 [21.1%] vs. 240/2172 [11.0%], adjusted odds ratio: 4.2, 95% CI: 1.60-10.98, p = 0.004). In addition, the administration of hydrocortisone was independent predictor of survival to discharge (hazard ratio: 4.6, p < 0.001). The results demonstrate a correlation between hydrocortisone administration and the high rates of survival to discharge.

Original languageEnglish
Article number17919
JournalScientific reports
Volume7
Issue number1
DOIs
Publication statusPublished - Dec 1 2017

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    Niimura, T., Zamami, Y., Koyama, T., Izawa-Ishizawa, Y., Miyake, M., Koga, T., Harada, K., Ohshima, A., Imai, T., Kondo, Y., Imanishi, M., Takechi, K., Fukushima, K., Horinouchi, Y., Ikeda, Y., Fujino, H., Tsuchiya, K., Tamaki, T., Hinotsu, S., ... Ishizawa, K. (2017). Hydrocortisone administration was associated with improved survival in Japanese patients with cardiac arrest. Scientific reports, 7(1), [17919]. https://doi.org/10.1038/s41598-017-17686-3