Background : Choking is increasing with aging, and cases of choking-induced cardiac arrest are increasing. However, few studies have examined the prognosis of choking-induced cardiac arrest. The aim of this study was to reveal the long-term prognosis of choking-induced cardiac arrest after resuscitation.
Methods : W We used the Shizuoka Kokuho Database. This database consists of claim data of approximately 2.2 million people during April 2012 to September 2018. From the database, we selected patients with choking-induced cardiac arrest who received cardiopulmonary resuscitation in the hospital.. Patients were excluded if they were under 20 years old, had an upper airway tumor, were on ventilator control, were fed enteral nutrition in the month prior to cardiac arrest. The primary outcome was death, and secondary outcomes were the 3-month survival rate, independence on devices. Descriptive statistics are presented and compared across age groups (20-64 years, 65-74 years, 75-84 years, 85 years and older), and survival time analysis (Kaplan-Meier method) was performed.
Results : A total of 268 patients were analyzed: 26 patients in the 20-64 age group, 33 patients in the 65-74 age group, 70 patients in the 75-84 age group, and 139 patients in the ≥85 age group. The 3-month survival rate was 5.6% (15/268). For each group, it was 3.8% (1/26) in the 20-64 age group; 15.2% (5/33) in the 65-74 age group; 8.6% (6/70) in the 75-84 age group; and 2.2% (3/139) in the ≥85 age group. The 12-month survival rate was 2.6% (7/268). Of the 7 patients who survived 12 months, 3 were on ventilator management and 5 were on tube and intravenous feedings at 3 months. These survivors were still on ventilators and tube feedings in the hospital and had not been discharged at 12 months.
Conclusions : The prognosis of choking-induced cardiac arrest was extremely poor when patients were not resuscitated before arrival at the hospital. Even if they survived, they were mostly dependent on assistive devices. In addition, none of the survivors dependent on assistive devices had discontinued the use of the devices even at long-term follow-up.