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Hayashida, Kei

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Hayashida

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Kei

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Hayashida, Kei
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    A novel early risk assessment tool for detecting clinical outcomes in patients with heat-related illness (J-ERATO score): Development and validation in independent cohorts in Japan
    (Public Library of Science, 2018) Hayashida, Kei; Kondo, Yutaka; Hifumi, Toru; Shimazaki, Junya; Oda, Yasutaka; Shiraishi, Shinichiro; Fukuda, Tatsuma; Sasaki, Junichi; Shimizu, Keiki
    Background: We sought to develop a novel risk assessment tool to predict the clinical outcomes after heat-related illness. Methods: Prospective, multicenter observational study. Patients who transferred to emergency hospitals in Japan with heat-related illness were registered. The sample was divided into two parts: 60% to construct the score and 40% to validate it. A binary logistic regression model was used to predict hospital admission as a primary outcome. The resulting model was transformed into a scoring system. Results: A total of 3,001 eligible patients were analyzed. There was no difference in variables between development and validation cohorts. Based on the result of a logistic regression model in the development phase (n = 1,805), the J-ERATO score was defined as the sum of the six binary components in the prehospital setting (respiratory rate≥22 /min, Glasgow coma scale<15, systolic blood pressure≤100 mmHg, heart rate≥100 bpm, body temperature≥38°C, and age≥65 y), for a total score ranging from 0 to 6. In the validation phase (n = 1,196), the score had excellent discrimination (C-statistic 0.84; 95% CI 0.79–0.89, p<0.0001) and calibration (P>0.2 by Hosmer-Lemeshow test). The observed proportion of hospital admission increased with increasing J-ERATO score (score = 0, 5.0%; score = 1, 15.0%; score = 2, 24.6%; score = 3, 38.6%; score = 4, 68.0%; score = 5, 85.2%; score = 6, 96.4%). Multivariate analyses showed that the J-ERATO score was an independent positive predictor of hospital admission (adjusted OR, 2.43; 95% CI, 2.06–2.87; P<0.001), intensive care unit (ICU) admission (3.73; 2.95–4.72; P<0.001) and in-hospital mortality (1.65; 1.18–2.32; P = 0.004). Conclusions: The J-ERATO score is simply assessed and can facilitate the identification of patients with higher risk of heat-related hospitalization. This scoring system is also significantly associated with the higher likelihood of ICU admission and in-hospital mortality after heat-related hospitalization.
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    Mechanical Cardiopulmonary Resuscitation and Hospital Survival Among Adult Patients With Nontraumatic Out‐of‐Hospital Cardiac Arrest Attending the Emergency Department: A Prospective, Multicenter, Observational Study in Japan (SOS‐KANTO [Survey of Survivors after Out‐of‐Hospital Cardiac Arrest in Kanto Area] 2012 Study)
    (John Wiley and Sons Inc., 2017) Hayashida, Kei; Tagami, Takashi; Fukuda, Tatsuma; Suzuki, Masaru; Yonemoto, Naohiro; Kondo, Yutaka; Ogasawara, Tomoko; Sakurai, Atsushi; Tahara, Yoshio; Nagao, Ken; Yaguchi, Arino; Morimura, Naoto; Kitamura, Nobuya; Nomura, Tomohisa; Shimizu, Naoki; Akashi, Akiko; Inokuchi, Sadaki; Masui, Yoshihiro; Miura, Kunihisa; Tsutsumi, Haruhiko; Takuma, Kiyotsugu; Atsushi, Ishihara; Nakano; Tanaka, Hiroshi; Ikegami, Keiichi; Arai, Takao; Oda, Shigeto; Kobayashi, Kenji; Suda, Takayuki; Ono, Kazuyuki; Furuya, Ryosuke; Koido, Yuichi; Iwase, Fumiaki; Kanesaka, Shigeru; Okada, Yasusei; Unemoto, Kyoko; Sadahiro, Tomohito; Iyanaga, Masayuki; Muraoka, Asaki; Hayashi, Munehiro; Miyake, Yasufumi; Yokokawa, Hideo; Koyama, Yasuaki; Tsuchiya, Asuka; Kashiyama, Tetsuya; Hayashi, Munetaka; Oshima, Kiyohiro; Kiyota, Kazuya; Hamabe, Yuichi; Yokota, Hiroyuki; Hori, Shingo; Inaba, Shin; Sakamoto, Tetsuya; Harada, Naoshige; Kimura, Akio; Kanai, Masayuki; Otomo, Yasuhiro; Sugita, Manabu; Kinoshita, Kosaku; Sakurai, Takatoshi; Kitano, Mitsuhide; Matsuda, Kiyoshi; Tanaka, Kotaro; Yoshihara, Katsunori; Yoh, Kikuo; Suzuki, Junichi; Toyoda, Hiroshi; Mashiko, Kunihiro; Muguruma, Takashi; Shimada, Tadanaga; Kobe, Yoshiro; Shoko, Tomohisa; Nakanishi, Kazuya; Shiga, Takashi; Yamamoto, Takefumi; Sekine, Kazuhiko; Izuka, Shinichi
    Background: Mechanical cardiopulmonary resuscitation (mCPR) for patients with out‐of‐hospital cardiac arrest attending the emergency department has become more widespread in Japan. The objective of this study is to determine the association between the mCPR in the emergency department and clinical outcomes. Methods and Results: In a prospective, multicenter, observational study, adult patients with out‐of‐hospital cardiac arrest with sustained circulatory arrest on hospital arrival were identified. The primary outcome was survival to hospital discharge. The secondary outcomes included a return of spontaneous circulation and successful hospital admission. Multivariate analyses adjusted for potential confounders and within‐institution clustering effects using a generalized estimation equation were used to analyze the association of the mCPR with outcomes. Between January 1, 2012 and March 31, 2013, 6537 patients with out‐of‐hospital cardiac arrest were eligible; this included 5619 patients (86.0%) in the manual CPR group and 918 patients (14.0%) in the mCPR group. Of those patients, 28.1% (1801/6419) showed return of spontaneous circulation in the emergency department, 20.4% (1175/5754) had hospital admission, 2.6% (168/6504) survived to hospital discharge, and 1.2% (75/6419) showed a favorable neurological outcome at 1 month after admission. Multivariate analyses revealed that mCPR was associated with a decreased likelihood of survival to hospital discharge (adjusted odds ratio, 0.40; 95% confidence interval, 0.20–0.78; P=0.005), return of spontaneous circulation (adjusted odds ratio, 0.71; 95% confidence interval, 0.53–0.94; P=0.018), and hospital admission (adjusted odds ratio, 0.57; 95% confidence interval, 0.40–0.80; P=0.001). Conclusions: After accounting for potential confounders, the mCPR in the emergency department was associated with decreased likelihoods of good clinical outcomes after adult nontraumatic out‐of‐hospital cardiac arrest. Further studies are needed to clarify circumstances in which mCPR may benefit these patients.
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    Thiosulfate Mediates Cytoprotective Effects of Hydrogen Sulfide Against Neuronal Ischemia
    (John Wiley and Sons Inc., 2015) Marutani, Eizo; Yamada, Marina; Ida, Tomoaki; Tokuda, Kentaro; Ikeda, Kohei; Kai, Shinichi; Shirozu, Kazuhiro; Hayashida, Kei; Kosugi, Shizuko; Hanaoka, Kenjiro; Kaneki, Masao; Akaike, Takaaki; Ichinose, Fumito
    Background: Hydrogen sulfide (H2S) exhibits protective effects in various disease models including cerebral ischemia–reperfusion (I/R) injury. Nonetheless, mechanisms and identity of molecules responsible for neuroprotective effects of H2S remain incompletely defined. In the current study, we observed that thiosulfate, an oxidation product of H2S, mediates protective effects of an H2S donor compound sodium sulfide (Na2S) against neuronal I/R injury. Methods and Results: We observed that thiosulfate in cell culture medium is not only required but also sufficient to mediate cytoprotective effects of Na2S against oxygen glucose deprivation and reoxygenation of human neuroblastoma cell line (SH‐SY5Y) and murine primary cortical neurons. Systemic administration of sodium thiosulfate (STS) improved survival and neurological function of mice subjected to global cerebral I/R injury. Beneficial effects of STS, as well as Na2S, were associated with marked increase of thiosulfate, but not H2S, in plasma and brain tissues. These results suggest that thiosulfate is a circulating “carrier” molecule of beneficial effects of H2S. Protective effects of thiosulfate were associated with inhibition of caspase‐3 activity by persulfidation at Cys163 in caspase‐3. We discovered that an SLC13 family protein, sodium sulfate cotransporter 2 (SLC13A4, NaS‐2), facilitates transport of thiosulfate, but not sulfide, across the cell membrane, regulating intracellular concentrations and thus mediating cytoprotective effects of Na2S and STS. Conclusions: The protective effects of H2S are mediated by thiosulfate that is transported across cell membrane by NaS‐2 and exerts antiapoptotic effects via persulfidation of caspase‐3. Given the established safety track record, thiosulfate may be therapeutic against ischemic brain injury.