Association between Survival and Time of On-Scene Resuscitation in Refractory Out-of-Hospital Cardiac Arrest: A Cross-Sectional Retrospective Study
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Data Collection
2.2. Study Setting
2.3. Study Population
2.4. Main Outcomes
2.5. Definition of Variables
2.6. Statistical Analysis
3. Results
3.1. Baseline Characteristics and Clinical Outcomes
3.2. Association between STI and Clinical Outcomes
3.3. Association between STI and Good Neurological Outcome Stratified by TTI
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Total | Non-Survival Discharge | Survival Discharge | p | |||
---|---|---|---|---|---|---|---|
n | % | n | % | n | % | ||
344 | 246 | 98 | |||||
Age, years (mean, SD) | 59.0 | 13.7 | 61.0 | 14.2 | 54.2 | 11.1 | <0.001 |
Sex, male | 283 | 82.3 | 202 | 82.1 | 81 | 82.7 | 0.91 |
Smoking status | <0.001 | ||||||
Current smoker | 61 | 17.7 | 33 | 13.4 | 28 | 28.6 | |
Ex-smoker | 23 | 6.7 | 12 | 4.9 | 11 | 11.2 | |
Never smoker | 23 | 6.7 | 42 | 17.1 | 33 | 33.7 | |
Missing | 185 | 53.8 | 159 | 64.6 | 26 | 26.5 | |
Hypertension | 125 | 36.3 | 88 | 35.8 | 37 | 37.8 | <0.001 |
Diabetes | 60 | 17.4 | 46 | 18.7 | 14 | 14.3 | <0.001 |
Time of event | 0.87 | ||||||
07:00–19:00 (day) | 192 | 55.8 | 138 | 56.1 | 54 | 55.1 | |
19:00–07:00 (night) | 152 | 44.2 | 108 | 43.9 | 44 | 44.9 | |
Day of week | 0.93 | ||||||
Weekday | 227 | 66.0 | 162 | 65.9 | 65 | 66.3 | |
Weekend, holidays | 117 | 34.0 | 84 | 34.1 | 33 | 33.7 | |
Witnessed (yes) | 258 | 75.0 | 183 | 74.4 | 75 | 76.5 | 0.53 |
Bystander CPR (yes) | 213 | 61.9 | 155 | 63.0 | 58 | 59.2 | 0.51 |
Arrest location | 0.36 | ||||||
Non-public | 175 | 50.9 | 129 | 52.4 | 46 | 46.9 | |
Public | 169 | 49.1 | 117 | 47.6 | 52 | 53.1 | |
RTI, minutes | 8 | (6–10) | 8 | (6–10) | 7 | (6–8) | 0.003 |
STI, minutes | 15 | (13–19) | 16 | (13–21) | 14 | (12–16) | <0.001 |
STI groups | <0.001 | ||||||
<15 min | 151 | 43.9 | 91 | 37.0 | 60 | 61.2 | |
≥15 min | 193 | 56.1 | 155 | 63.0 | 38 | 38.8 | |
TTI, minutes | 7 | (4–10) | 7 | (4–10) | 7 | (4–10) | 0.90 |
TPT, minutes | 31 | (26–37) | 32 | (27–38) | 29 | (25–33) | <0.001 |
Number of shocks delivered | 4 | (3–6) | 5 | (4–6) | 4 | (3–5) | 0.002 |
Airway types | 0.003 | ||||||
Bag valve mask | 80 | 23.3 | 53 | 21.5 | 27 | 27.6 | |
Supraglottic airway | 230 | 66.9 | 176 | 71.5 | 54 | 55.1 | |
Endotracheal intubation | 34 | 9.9 | 17 | 6.9 | 17 | 17.3 | |
Prehospital epinephrine given | 84 | 24.4 | 73 | 29.7 | 11 | 11.2 | <0.001 |
Prehospital amiodarone given | 42 | 12.2 | 39 | 15.9 | 3 | 3.1 | 0.001 |
Prehospital ROSC | 99 | 28.8 | 27 | 11.0 | 72 | 73.5 | <0.001 |
ECLS applied | 26 | 7.6 | 17 | 6.9 | 9 | 9.2 | 0.47 |
TTM applied | 62 | 18.0 | 16 | 6.5 | 46 | 46.9 | <0.001 |
Good neurological outcome | 83 | 24.1 | 0 | 0.0 | 83 | 84.7 | <0.001 |
Variables | Total | Prehospital ROSC | Without Prehospital ROSC | p | |||
---|---|---|---|---|---|---|---|
344 | 99 | 245 | |||||
RTI, minutes | 8 | (6–10) | 7 | (6–9) | 8 | (6–10) | 0.02 |
STI, minutes | 15 | (13–19) | 14 | (12–18) | 16 | (13–21) | 0.001 |
STI groups | 0.01 | ||||||
<15 min | 151 | 43.9 | 55 | 55.6 | 96 | 39.2 | |
≥15 min | 193 | 56.1 | 44 | 44.4 | 149 | 60.8 | |
TTI, minutes | 7 | (4–10) | 8 | (4–11) | 6 | (4–9) | 0.07 |
TPT, minutes | 31 | (26–37) | 29 | (25–35) | 32 | (27–37) | 0.07 |
EMS arrival to Prehospital ROSC | 12 | (9–16) | |||||
Survival discharge | 98 | 28.5 | 72 | 72.7 | 26 | 10.6 | <0.001 |
Good neurological outcome | 83 | 24.1 | 65 | 65.7 | 18 | 7.3 | <0.001 |
Variables | Survival Discharge | Good Neurological Outcome | ||||||
---|---|---|---|---|---|---|---|---|
OR | 95% CI | aOR | 95% CI | OR | 95% CI | aOR | 95% CI | |
STI ≥ 15 min (<15 min) | 0.37 | (0.23–0.60) | 0.33 | (0.17–0.65) | 0.42 | (0.25–0.69) | 0.43 | (0.22–0.86) |
Age, years | 0.96 | (0.95–0.98) | 0.95 | (0.93–0.97) | 0.96 | (0.94–0.98) | 0.95 | (0.93–0.98) |
Male | 1.04 | (0.56–1.92) | 0.78 | (0.34–1.78) | 0.97 | (0.51–1.85) | 0.69 | (0.29–1.64) |
Bystander CPR done | 0.85 | (0.53–1.37) | 0.90 | (0.47–1.72) | 0.97 | (0.59–1.62) | 1.08 | (0.55–2.13) |
Public location (non-public) | 1.25 | (0.78–1.99) | 0.77 | (0.4–1.51) | 1.49 | (0.9–2.45) | 1.14 | (0.57–2.26) |
RTI, minute | 0.89 | (0.81–0.97) | 0.89 | (0.78–1.00) | 0.91 | (0.83–0.99) | 0.92 | (0.81–1.04) |
TTI, minute | 1.03 | (1.00–1.06) | 1.02 | (0.98–1.06) | 1.03 | (1.00–1.06) | 1.02 | (0.98–1.06) |
Supraglottic airway (bag valve mask) | 0.60 | (0.35–1.05) | 0.78 | (0.37–1.65) | 0.74 | (0.41–1.34) | 1.09 | (0.49–2.41) |
Endotracheal intubation (bag valve mask) | 1.96 | (0.87–4.44) | 2.29 | (0.74–7.11) | 1.97 | (0.85–4.58) | 2.43 | (0.76–7.80) |
Prehospital ROSC | 22.46 | (12.32–40.96) | 21.65 | (11.19–41.90) | 24.11 | (12.79–45.47) | 22.05 | (11.19–43.48) |
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Park, H.A.; Ahn, K.O.; Lee, E.J.; Park, J.O.; on behalf of the Korean Cardiac Arrest Research Consortium (KoCARC) Investigators. Association between Survival and Time of On-Scene Resuscitation in Refractory Out-of-Hospital Cardiac Arrest: A Cross-Sectional Retrospective Study. Int. J. Environ. Res. Public Health 2021, 18, 496. https://doi.org/10.3390/ijerph18020496
Park HA, Ahn KO, Lee EJ, Park JO, on behalf of the Korean Cardiac Arrest Research Consortium (KoCARC) Investigators. Association between Survival and Time of On-Scene Resuscitation in Refractory Out-of-Hospital Cardiac Arrest: A Cross-Sectional Retrospective Study. International Journal of Environmental Research and Public Health. 2021; 18(2):496. https://doi.org/10.3390/ijerph18020496
Chicago/Turabian StylePark, Hang A, Ki Ok Ahn, Eui Jung Lee, Ju Ok Park, and on behalf of the Korean Cardiac Arrest Research Consortium (KoCARC) Investigators. 2021. "Association between Survival and Time of On-Scene Resuscitation in Refractory Out-of-Hospital Cardiac Arrest: A Cross-Sectional Retrospective Study" International Journal of Environmental Research and Public Health 18, no. 2: 496. https://doi.org/10.3390/ijerph18020496