病院間連携で社会復帰を目指す : 約１０分間の心停止にも関わらず病院間連携で社会復帰したBrugada症候群の一例を通じて

Background : We present a case of Brugada syndrome, who fully recovered from out-ofhospital cardiac arrest（OHCA）because of good coordination between the emergency room（ER） of a community hospital and the intensive care unit（ICU）of a university hospital. However, effects of inter-hospital coordination on outcomes after OHCA need further elucidation. Objectives : To clarify the role of inter-hospital coordination in OHCA cases in Tokushima City, Tokushima, Japan. Methods : In accordance with the Utstein-style, we reviewed medical records of OHCA patients who visited our ER from April２００９to December２０１１. Results : Of１４９cases,５３patients achieved return of spontaneous circulation（ROSC）after OHCA. While seven patients experienced witnessed cardiogenic arrest due to ventricular fibrillation, ３patients（４２．９％）among them survived at １month and ２patients（２８．６％）obtained satisfactory neurological recovery. Discussions : The survival rate of OHCA patients in our ER was better compared to the national survey. We speculated the reason of good outcome was that we appropriately transferred the patients to the advanced hospital ICU for high-integrity care. Good inter-hospital coordination should be organized to enhance full recovery in OHCA patients. This strategy may also prevent the concentration of patients requiring emergency medical care to few specific hospitals such as emergency medical centers. Conclusions : We rescued a case of OHCA thanks to good inter-hospital coordination. We should develop a safety net further for community residents.

四国医学雑誌 : http://www.tokushima-u.ac.jp/med/research/shikoku_acta_medica.html