Characteristics and outcomes of bath-related out-of-hospital cardiac arrest in Japan

Kosuke Kiyohara, Chika Nishiyama, Sumito Hayashida, Tasuku Matsuyama, Toshihiro Hatakeyama, Tomonari Shimamoto, Junichi Izawa, Tomoko Fujii, Yusuke Katayama, Taku Iwami, Tetsuhisa Kitamura

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Background: Characteristics and outcomes of emergency patients with bath-related sudden cardiac arrest in prehospital settings have not been sufficiently investigated. Methods and Results: From a prospective population-based registry, which covers all out-of-hospital cardiac arrests (OHCAs) in Osaka City, a total of 642 patients who had a bath-related OHCA from 2012 to 2014 were enrolled in the analyses. The characteristics and outcomes of OHCA were compared by three locations of arrest: home baths (n=512), public baths (n=102), and baths in other public institutions (n=28). Overall, bath-related OHCAs mainly occurred in winter (December–February, 48.9%, 314/642). The proportion of OHCAs that were witnessed by bystanders was 6.4% (33/512) in home baths, 17.6% (18/102) in public baths, and 25.0% (7/28) in baths in other public institutions. The proportion of public-access automated external defibrillator pad application was 0.8% (4/512) in home baths, 6.9% (7/102) in public baths, and 50.0% (14/28) in baths in other public institutions. Only 1 survivor with a favorable neurologic outcome was observed in a home bath, whereas there were no patients who survived with favorable neurologic outcomes in public baths and baths in other public institutions. Conclusions: Bath-related OHCAs mainly occurred in winter, and the outcome of victims was exceedingly poor, irrespective of location of arrest. The establishment of preventive measures as well as earlier recognition of cardiac arrest by bystanders are needed.

Original languageEnglish
Pages (from-to)1564-1570
Number of pages7
JournalCirculation Journal
Issue number7
Publication statusPublished - 1 Jan 2016
Externally publishedYes


  • Bath
  • Cardiopulmonary resuscitation
  • Out-of-hospital cardiac arrest
  • Outcomes

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