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The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial
Abstract Background Previous research has demonstrated significant relationships between peri-shock pause and survival to discharge from out-of-hospital shockable cardiac arrest (OHCA). Objective To determine the impact of peri-shock pause on survival from OHCA during the ROC PRIMED randomized contr...
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| Published in: | Resuscitation 2014-03, Vol.85 (3), p.336-342 |
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| creator | Cheskes, Sheldon Schmicker, Robert H Verbeek, P. Richard Salcido, David D Brown, Siobhan P Brooks, Steven Menegazzi, James J Vaillancourt, Christian Powell, Judy May, Susanne Berg, Robert A Sell, Rebecca Idris, Ahamed Kampp, Mike Schmidt, Terri Christenson, Jim |
| description | Abstract Background Previous research has demonstrated significant relationships between peri-shock pause and survival to discharge from out-of-hospital shockable cardiac arrest (OHCA). Objective To determine the impact of peri-shock pause on survival from OHCA during the ROC PRIMED randomized controlled trial. Methods We included patients in the ROC PRIMED trial who suffered OHCA between June 2007 and November 2009, presented with a shockable rhythm and had CPR process data for at least one shock. We used multivariable logistic regression to determine the association between peri-shock pause duration and survival to hospital discharge. Results Among 2006 patients studied, the median (IQR) shock pause duration was: pre-shock pause 15 s (8, 22); post-shock pause 6 s (4, 9); and peri-shock pause 22.0 s (14, 31). After adjusting for Utstein predictors of survival as well as CPR quality measures, the odds of survival to hospital discharge were significantly higher for patients with pre-shock pause |
| doi_str_mv | 10.1016/j.resuscitation.2013.10.014 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3944081</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0300957213008149</els_id><sourcerecordid>1501372115</sourcerecordid><originalsourceid>FETCH-LOGICAL-c612t-12648a83b6e6b08552cfda154d420ad9a64808158c9a2faa7b76f0dfde98c0ce3</originalsourceid><addsrcrecordid>eNqNkt1u1DAQhSMEotvCKyBL3HCTxXbi_AipEloWqFRUVMq1NWtPut4mcfDPSn0NnrgOW6qWK67m4pz5ZuwzWfaW0SWjrHq_Wzr00SsTIBg7LjllRVKWlJXPsgVr6iJnoqbPswUtKM1bUfOj7Nj7HaW0EG39MjvipWAF4-0i-321RWKGCVQgtiMTOpP7rVU3ZILokdiR-Oj2Zg896ZwdiI0ht12-tX5KC_Tkjxk2PRIFThtQBFzaLxAdnRmvSUj8y8f7kosYlB3Qk5UdvXXBxIF8vzz7tv5EgjPQv8pedNB7fH1fT7Kfn9dXq6_5-cWXs9XH81xVjIec8apsoCk2FVYb2gjBVaeBiVKXnIJuIcm0YaJRLfAOoN7UVUd1p7FtFFVYnGSnB-4UNwNqhWNw0MvJmQHcrbRg5FNlNFt5bfeyaMsykRPg3T3A2V8xvVkOxivsexjRRi-ZSMnUnDGRrB8OVuWs9w67hzGMyjlVuZNPUpVzqrOYUk3dbx5v-tD7N8ZkWB8MmP5rb9DJBMJRoTYOVZDamv8cdPoPR_VmNAr6G7xFv7PRjSkSyaTnksof84HN98VSbVjZFnebcdUx</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1501372115</pqid></control><display><type>article</type><title>The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial</title><source>ScienceDirect Freedom Collection</source><creator>Cheskes, Sheldon ; Schmicker, Robert H ; Verbeek, P. Richard ; Salcido, David D ; Brown, Siobhan P ; Brooks, Steven ; Menegazzi, James J ; Vaillancourt, Christian ; Powell, Judy ; May, Susanne ; Berg, Robert A ; Sell, Rebecca ; Idris, Ahamed ; Kampp, Mike ; Schmidt, Terri ; Christenson, Jim</creator><creatorcontrib>Cheskes, Sheldon ; Schmicker, Robert H ; Verbeek, P. Richard ; Salcido, David D ; Brown, Siobhan P ; Brooks, Steven ; Menegazzi, James J ; Vaillancourt, Christian ; Powell, Judy ; May, Susanne ; Berg, Robert A ; Sell, Rebecca ; Idris, Ahamed ; Kampp, Mike ; Schmidt, Terri ; Christenson, Jim ; Resuscitation Outcomes Consortium (ROC) investigators ; Resuscitation Outcomes Consortium (ROC) investigators</creatorcontrib><description>Abstract Background Previous research has demonstrated significant relationships between peri-shock pause and survival to discharge from out-of-hospital shockable cardiac arrest (OHCA). Objective To determine the impact of peri-shock pause on survival from OHCA during the ROC PRIMED randomized controlled trial. Methods We included patients in the ROC PRIMED trial who suffered OHCA between June 2007 and November 2009, presented with a shockable rhythm and had CPR process data for at least one shock. We used multivariable logistic regression to determine the association between peri-shock pause duration and survival to hospital discharge. Results Among 2006 patients studied, the median (IQR) shock pause duration was: pre-shock pause 15 s (8, 22); post-shock pause 6 s (4, 9); and peri-shock pause 22.0 s (14, 31). After adjusting for Utstein predictors of survival as well as CPR quality measures, the odds of survival to hospital discharge were significantly higher for patients with pre-shock pause <10 s (OR: 1.52, 95% CI: 1.09, 2.11) and peri-shock pause <20 s (OR: 1.82, 95% CI: 1.17, 2.85) when compared to patients with pre-shock pause ≥20 s and peri-shock pause ≥40 s. Post-shock pause was not significantly associated with survival to hospital discharge. Results for neurologically intact survival (Modified Rankin Score ≤ 3) were similar to our primary outcome. Conclusions In patients with cardiac arrest presenting in a shockable rhythm during the ROC PRIMED trial, shorter pre- and peri-shock pauses were significantly associated with higher odds of survival. Future cardiopulmonary education and technology should focus on minimizing all peri-shock pauses.</description><identifier>ISSN: 0300-9572</identifier><identifier>ISSN: 1873-1570</identifier><identifier>EISSN: 1873-1570</identifier><identifier>DOI: 10.1016/j.resuscitation.2013.10.014</identifier><identifier>PMID: 24513129</identifier><language>eng</language><publisher>Ireland: Elsevier Ireland Ltd</publisher><subject>Aged ; Cardiopulmonary resuscitation ; Cardiopulmonary Resuscitation - methods ; Emergency ; Female ; Heart arrest ; Humans ; Male ; Middle Aged ; Out-of-Hospital Cardiac Arrest - mortality ; Out-of-Hospital Cardiac Arrest - therapy ; Resuscitation ; Survival ; Survival Rate ; Time Factors ; Treatment Outcome</subject><ispartof>Resuscitation, 2014-03, Vol.85 (3), p.336-342</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2013 Elsevier Ireland Ltd</rights><rights>Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.</rights><rights>2013 Published by Elsevier Ireland Ltd. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c612t-12648a83b6e6b08552cfda154d420ad9a64808158c9a2faa7b76f0dfde98c0ce3</citedby><cites>FETCH-LOGICAL-c612t-12648a83b6e6b08552cfda154d420ad9a64808158c9a2faa7b76f0dfde98c0ce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24513129$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cheskes, Sheldon</creatorcontrib><creatorcontrib>Schmicker, Robert H</creatorcontrib><creatorcontrib>Verbeek, P. Richard</creatorcontrib><creatorcontrib>Salcido, David D</creatorcontrib><creatorcontrib>Brown, Siobhan P</creatorcontrib><creatorcontrib>Brooks, Steven</creatorcontrib><creatorcontrib>Menegazzi, James J</creatorcontrib><creatorcontrib>Vaillancourt, Christian</creatorcontrib><creatorcontrib>Powell, Judy</creatorcontrib><creatorcontrib>May, Susanne</creatorcontrib><creatorcontrib>Berg, Robert A</creatorcontrib><creatorcontrib>Sell, Rebecca</creatorcontrib><creatorcontrib>Idris, Ahamed</creatorcontrib><creatorcontrib>Kampp, Mike</creatorcontrib><creatorcontrib>Schmidt, Terri</creatorcontrib><creatorcontrib>Christenson, Jim</creatorcontrib><creatorcontrib>Resuscitation Outcomes Consortium (ROC) investigators</creatorcontrib><creatorcontrib>Resuscitation Outcomes Consortium (ROC) investigators</creatorcontrib><title>The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial</title><title>Resuscitation</title><addtitle>Resuscitation</addtitle><description>Abstract Background Previous research has demonstrated significant relationships between peri-shock pause and survival to discharge from out-of-hospital shockable cardiac arrest (OHCA). Objective To determine the impact of peri-shock pause on survival from OHCA during the ROC PRIMED randomized controlled trial. Methods We included patients in the ROC PRIMED trial who suffered OHCA between June 2007 and November 2009, presented with a shockable rhythm and had CPR process data for at least one shock. We used multivariable logistic regression to determine the association between peri-shock pause duration and survival to hospital discharge. Results Among 2006 patients studied, the median (IQR) shock pause duration was: pre-shock pause 15 s (8, 22); post-shock pause 6 s (4, 9); and peri-shock pause 22.0 s (14, 31). After adjusting for Utstein predictors of survival as well as CPR quality measures, the odds of survival to hospital discharge were significantly higher for patients with pre-shock pause <10 s (OR: 1.52, 95% CI: 1.09, 2.11) and peri-shock pause <20 s (OR: 1.82, 95% CI: 1.17, 2.85) when compared to patients with pre-shock pause ≥20 s and peri-shock pause ≥40 s. Post-shock pause was not significantly associated with survival to hospital discharge. Results for neurologically intact survival (Modified Rankin Score ≤ 3) were similar to our primary outcome. Conclusions In patients with cardiac arrest presenting in a shockable rhythm during the ROC PRIMED trial, shorter pre- and peri-shock pauses were significantly associated with higher odds of survival. Future cardiopulmonary education and technology should focus on minimizing all peri-shock pauses.</description><subject>Aged</subject><subject>Cardiopulmonary resuscitation</subject><subject>Cardiopulmonary Resuscitation - methods</subject><subject>Emergency</subject><subject>Female</subject><subject>Heart arrest</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Out-of-Hospital Cardiac Arrest - mortality</subject><subject>Out-of-Hospital Cardiac Arrest - therapy</subject><subject>Resuscitation</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0300-9572</issn><issn>1873-1570</issn><issn>1873-1570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNqNkt1u1DAQhSMEotvCKyBL3HCTxXbi_AipEloWqFRUVMq1NWtPut4mcfDPSn0NnrgOW6qWK67m4pz5ZuwzWfaW0SWjrHq_Wzr00SsTIBg7LjllRVKWlJXPsgVr6iJnoqbPswUtKM1bUfOj7Nj7HaW0EG39MjvipWAF4-0i-321RWKGCVQgtiMTOpP7rVU3ZILokdiR-Oj2Zg896ZwdiI0ht12-tX5KC_Tkjxk2PRIFThtQBFzaLxAdnRmvSUj8y8f7kosYlB3Qk5UdvXXBxIF8vzz7tv5EgjPQv8pedNB7fH1fT7Kfn9dXq6_5-cWXs9XH81xVjIec8apsoCk2FVYb2gjBVaeBiVKXnIJuIcm0YaJRLfAOoN7UVUd1p7FtFFVYnGSnB-4UNwNqhWNw0MvJmQHcrbRg5FNlNFt5bfeyaMsykRPg3T3A2V8xvVkOxivsexjRRi-ZSMnUnDGRrB8OVuWs9w67hzGMyjlVuZNPUpVzqrOYUk3dbx5v-tD7N8ZkWB8MmP5rb9DJBMJRoTYOVZDamv8cdPoPR_VmNAr6G7xFv7PRjSkSyaTnksof84HN98VSbVjZFnebcdUx</recordid><startdate>20140301</startdate><enddate>20140301</enddate><creator>Cheskes, Sheldon</creator><creator>Schmicker, Robert H</creator><creator>Verbeek, P. Richard</creator><creator>Salcido, David D</creator><creator>Brown, Siobhan P</creator><creator>Brooks, Steven</creator><creator>Menegazzi, James J</creator><creator>Vaillancourt, Christian</creator><creator>Powell, Judy</creator><creator>May, Susanne</creator><creator>Berg, Robert A</creator><creator>Sell, Rebecca</creator><creator>Idris, Ahamed</creator><creator>Kampp, Mike</creator><creator>Schmidt, Terri</creator><creator>Christenson, Jim</creator><general>Elsevier Ireland Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140301</creationdate><title>The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial</title><author>Cheskes, Sheldon ; Schmicker, Robert H ; Verbeek, P. Richard ; Salcido, David D ; Brown, Siobhan P ; Brooks, Steven ; Menegazzi, James J ; Vaillancourt, Christian ; Powell, Judy ; May, Susanne ; Berg, Robert A ; Sell, Rebecca ; Idris, Ahamed ; Kampp, Mike ; Schmidt, Terri ; Christenson, Jim</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c612t-12648a83b6e6b08552cfda154d420ad9a64808158c9a2faa7b76f0dfde98c0ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Cardiopulmonary resuscitation</topic><topic>Cardiopulmonary Resuscitation - methods</topic><topic>Emergency</topic><topic>Female</topic><topic>Heart arrest</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Out-of-Hospital Cardiac Arrest - mortality</topic><topic>Out-of-Hospital Cardiac Arrest - therapy</topic><topic>Resuscitation</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cheskes, Sheldon</creatorcontrib><creatorcontrib>Schmicker, Robert H</creatorcontrib><creatorcontrib>Verbeek, P. Richard</creatorcontrib><creatorcontrib>Salcido, David D</creatorcontrib><creatorcontrib>Brown, Siobhan P</creatorcontrib><creatorcontrib>Brooks, Steven</creatorcontrib><creatorcontrib>Menegazzi, James J</creatorcontrib><creatorcontrib>Vaillancourt, Christian</creatorcontrib><creatorcontrib>Powell, Judy</creatorcontrib><creatorcontrib>May, Susanne</creatorcontrib><creatorcontrib>Berg, Robert A</creatorcontrib><creatorcontrib>Sell, Rebecca</creatorcontrib><creatorcontrib>Idris, Ahamed</creatorcontrib><creatorcontrib>Kampp, Mike</creatorcontrib><creatorcontrib>Schmidt, Terri</creatorcontrib><creatorcontrib>Christenson, Jim</creatorcontrib><creatorcontrib>Resuscitation Outcomes Consortium (ROC) investigators</creatorcontrib><creatorcontrib>Resuscitation Outcomes Consortium (ROC) investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Resuscitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cheskes, Sheldon</au><au>Schmicker, Robert H</au><au>Verbeek, P. Richard</au><au>Salcido, David D</au><au>Brown, Siobhan P</au><au>Brooks, Steven</au><au>Menegazzi, James J</au><au>Vaillancourt, Christian</au><au>Powell, Judy</au><au>May, Susanne</au><au>Berg, Robert A</au><au>Sell, Rebecca</au><au>Idris, Ahamed</au><au>Kampp, Mike</au><au>Schmidt, Terri</au><au>Christenson, Jim</au><aucorp>Resuscitation Outcomes Consortium (ROC) investigators</aucorp><aucorp>Resuscitation Outcomes Consortium (ROC) investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial</atitle><jtitle>Resuscitation</jtitle><addtitle>Resuscitation</addtitle><date>2014-03-01</date><risdate>2014</risdate><volume>85</volume><issue>3</issue><spage>336</spage><epage>342</epage><pages>336-342</pages><issn>0300-9572</issn><issn>1873-1570</issn><eissn>1873-1570</eissn><abstract>Abstract Background Previous research has demonstrated significant relationships between peri-shock pause and survival to discharge from out-of-hospital shockable cardiac arrest (OHCA). Objective To determine the impact of peri-shock pause on survival from OHCA during the ROC PRIMED randomized controlled trial. Methods We included patients in the ROC PRIMED trial who suffered OHCA between June 2007 and November 2009, presented with a shockable rhythm and had CPR process data for at least one shock. We used multivariable logistic regression to determine the association between peri-shock pause duration and survival to hospital discharge. Results Among 2006 patients studied, the median (IQR) shock pause duration was: pre-shock pause 15 s (8, 22); post-shock pause 6 s (4, 9); and peri-shock pause 22.0 s (14, 31). After adjusting for Utstein predictors of survival as well as CPR quality measures, the odds of survival to hospital discharge were significantly higher for patients with pre-shock pause <10 s (OR: 1.52, 95% CI: 1.09, 2.11) and peri-shock pause <20 s (OR: 1.82, 95% CI: 1.17, 2.85) when compared to patients with pre-shock pause ≥20 s and peri-shock pause ≥40 s. Post-shock pause was not significantly associated with survival to hospital discharge. Results for neurologically intact survival (Modified Rankin Score ≤ 3) were similar to our primary outcome. Conclusions In patients with cardiac arrest presenting in a shockable rhythm during the ROC PRIMED trial, shorter pre- and peri-shock pauses were significantly associated with higher odds of survival. Future cardiopulmonary education and technology should focus on minimizing all peri-shock pauses.</abstract><cop>Ireland</cop><pub>Elsevier Ireland Ltd</pub><pmid>24513129</pmid><doi>10.1016/j.resuscitation.2013.10.014</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Cardiopulmonary resuscitation Cardiopulmonary Resuscitation - methods Emergency Female Heart arrest Humans Male Middle Aged Out-of-Hospital Cardiac Arrest - mortality Out-of-Hospital Cardiac Arrest - therapy Resuscitation Survival Survival Rate Time Factors Treatment Outcome |
| title | The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial |
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