Oct 21, 2016

Age-specific differences in prognostic significance of rhythm conversion from initial non-shockable to shockable rhythm and subsequent shock delivery in out-of-hospital cardiac arrest

Resuscitation
Akira FunadaMasakazu Yamagishi

Abstract

Early rhythm conversion from an initial non-shockable to a shockable rhythm and subsequent shock delivery in patients with out-of-hospital cardiac arrest (OHCA) has been associated with favourable neurological outcome (Cerebral Performance Category score 1 or 2; CPC 1-2). We hypothesized that the prognostic significance of rhythm conversion and subsequent shock delivery differs by age and time from initiation of cardiopulmonary resuscitation (CPR) by emergency medical service (EMS) providers to first defibrillation (shock delivery time). We analysed 430,443 OHCA patients with an initial non-shockable rhythm using a prospective Japanese Utstein-style database from 2011 to 2014. The primary endpoint was 1-month CPC 1-2. Multivariate logistic regression revealed that rhythm conversion and subsequent shock delivery is positively associated with 1-month CPC 1-2: the adjusted odds ratio was 6.09 (95% confidence interval: 3.65-9.75) for shock delivery time <10min and 3.34 (2.58-4.27) for 10-19min in patients aged 18-64 years, and 3.16 (1.45-6.09) for <10min and 2.17 (1.51-3.03) for 10-19min in patients aged 65-74 years. However, it is negatively associated with 1-month CPC 1-2 for shock delivery time of 20-59min in patients aged 75-84...Continue Reading

  • References18
  • Citations1

References

  • References18
  • Citations1

Mentioned in this Paper

Emergency Care
Brain
Transcription Initiation
Logistic Regression
Basic Cardiac Life Support
Shock
Sinus - General Anatomical Term
Odds Ratio
Etiology
Cardiopulmonary Resuscitation

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