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

Abstract Background 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 hypo...

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Bibliographic Details
Published in:Resuscitation 2016-11, Vol.108, p.61-67
Main Authors: Funada, Akira, Goto, Yoshikazu, Tada, Hayato, Teramoto, Ryota, Shimojima, Masaya, Hayashi, Kenshi, Yamagishi, Masakazu
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Cardiopulmonary resuscitation
Cardiopulmonary Resuscitation - methods
Cardiopulmonary Resuscitation - mortality
Databases, Factual
Defibrillation
Electric Countershock - methods
Electric Countershock - mortality
Emergency
Emergency Medical Services
Epidemiology
Female
Humans
Japan - epidemiology
Logistic Models
Male
Middle Aged
Odds Ratio
Out-of-hospital cardiac arrest
Out-of-Hospital Cardiac Arrest - mortality
Out-of-Hospital Cardiac Arrest - therapy
Population Surveillance
Prognosis
Prospective Studies
Time Factors
Young Adult
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Summary:Abstract Background 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). Methods 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. Results 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
ISSN:0300-9572
1873-1570
DOI:10.1016/j.resuscitation.2016.09.013