A Study of 72 Adult Patients with Cardiopulmonary Arrest Due to Food Asphyxia

Introduction: Japan has the highest proportion of elderly individuals globally and the incidence of food asphyxia has been steadily increasing. The purpose of this study was to evaluate patients with cardiopulmonary arrest resulting from food asphyxia. Methods: We retrospectively examined the medical records of 142 patients admitted to our center between January 2005 and December 2014 with cardiopulmonary arrest resulting from food asphyxia. We excluded patients <20 years of age or if relevant clinical data were missing. A total of 72 patients met the overall inclusion criteria. Results: Overall, 26 patients (36%) survived to hospital discharge, but their neurological prognosis was poor. 3 significant variables (pre-hospital medical treatment, time from emergency call to hospital arrival, and lactate level) were selected by stepwise logistic regression and multiple logistic regression was performed with those 3 selected variables. Only blood gas lactate level at the time of admission was an independent predictor of survival to hospital discharge. Receiver operating characteristic (ROC) analyses yielded the AUC=0.832 the optimal cut-off value for lactate levels was 10.1 mg/dL (sensitivity, 83% and specificity, 73%) by Youden Index. Conclusion: These study findings suggest that blood gas lactate level at the time of hospital admission can be a predictor for the outcome of patients with asphyxia