Association Between Annual Procedural Volume and Outcomes in Extracorporeal Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest: A Nationwide Cohort Study in Japan (the JAAM-OHCA Registry)
Extracorporeal cardiopulmonary resuscitation (ECPR) requires advanced skills for induction and management. This study evaluated whether the outcomes of ECPR differ by institutional volume. Using the Japanese Association for Acute Medicine-Out-of-Hospital Cardiac Arrest (JAAM-OHCA) registry, we analyzed adult patients (aged ≥18 years) who received ECPR between 2014 and 2020, focusing on 30 day in-hospital survival and favorable neurologic prognosis at 30 days defined as Cerebral Performance Category (CPC) 1-2. Facilities were categorized into tertiles by annual ECPR volume. Multivariable logistic regression examined outcomes across low (≤4.7 cases/year), medium (4.8-7.8 cases/year), and high (≥7.9 cases/year) volume groups. A total of 1,759 patients from 83 centers were included, with an overall 30 day survival of 21.1% and CPC 1-2 rate of 10.1%. We observed no statistically significant differences in the respective rates of 30 day survival and neurologic outcomes in the medium ECPR volume group (adjusted odds ratios 1.09 [95% confidence interval {CI}, 0.82-1.47] and 0.85 [0.56-1.26]) and higher ECPR volume group (adjusted odds ratios 1.27 [95% CI, 0.95-1.70] and 1.11 [0.75-1.63]) compared with the lower ECPR volume group. These findings suggest that ECPR outcomes for out-of-hospital cardiac arrest are not significantly affected by institutional ECPR volume.
Authors
- Takaya Morooka
- Takuya Ishibe
- Norihiro Nishioka (ORCID: https://orcid.org/0000-0001-5218-9819)
- Changhwi Park
- Kazuhisa Yoshiya
- Ling Zha (ORCID: https://orcid.org/0000-0003-4668-4199)
- Haruko Sakamoto
- Shunichiro Nakao (ORCID: https://orcid.org/0000-0001-5530-806X)
- Taku Iwami (ORCID: https://orcid.org/0000-0002-4150-7065)
- Shunsuke Kimata
- Jun Oda (ORCID: https://orcid.org/0000-0002-8254-3716)
- Tetsuhisa Kitamura (ORCID: https://orcid.org/0000-0003-0107-0580)
- Taro Irisawa
- Tasuku Matsuyama (ORCID: https://orcid.org/0000-0003-4068-0306)
- Yuto Makino (ORCID: https://orcid.org/0000-0002-8899-0613)
- Takeyuki Kiguchi (ORCID: https://orcid.org/0000-0003-0259-9531)
- Satoshi Yoshimura (ORCID: https://orcid.org/0000-0003-3490-2101)
- Atsunori Onoe
- Taku Sogabe (ORCID: https://orcid.org/0000-0002-3560-3851)
- Masafumi Kishimoto (ORCID: https://orcid.org/0000-0002-7450-5605)
- Satoshi Matsui (ORCID: https://orcid.org/0000-0001-6240-2011)
- Kosuke Kiyohara (ORCID: https://orcid.org/0000-0003-0644-6129)
- Yohei Okada (ORCID: https://orcid.org/0000-0002-2266-476X)
- Yusuke Ito (ORCID: https://orcid.org/0000-0002-1521-5931)
- Kazuma Yamakawa (ORCID: https://orcid.org/0000-0003-2999-4021)
- Shunsuke Kawai (ORCID: https://orcid.org/0000-0002-1822-6054)
- Tetsuro Nishimura
- Kohei Ninomiya (ORCID: https://orcid.org/0009-0006-4312-7118)
- Yuki Hironaka
- Tomoki Yamada
Institutions
- Kansai Medical University (JP)
- Apple (Israel) (IL)
- Otsuma Women's University (JP)
- Kyoto University (JP)
- Osaka Prefectural Medical Center (JP)
- Nagoya City University (JP)
- Kyoto Prefectural University of Medicine (JP)
- Novem (Netherlands) (NL)
- Osaka National Hospital (JP)
- Osaka City General Hospital (JP)
- Saiseikaisenri Hospital (JP)
- Osaka Police Hospital (JP)
- Kobe Children's Hospital (JP)
- Duke-NUS Medical School (SG)
- Tane General Hospital (JP)
- Kishiwada Tokushukai Hospital (JP)
- Osaka Red Cross Hospital (JP)
- Osaka Metropolitan University (JP)
- Senshu University (JP)
- Osaka University of Pharmaceutical Sciences (JP)
- Kindai University (JP)
- The University of Osaka (JP)
Publication Details
- Journal
- ASAIO Journal
- Published
- 2025-04-28
- DOI
- https://doi.org/10.1097/mat.0000000000002450
- Primary Topic
- Cardiac Arrest and Resuscitation
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Ministry of Education, Culture, Sports, Science and Technology