TY - JOUR
T1 - Subsequent ventricular fibrillation and survival in out-of-hospital cardiac arrests presenting with PEA or asystole
AU - Kajino, Kentaro
AU - Iwami, Taku
AU - Daya, Mohamud
AU - Nishiuchi, Tatsuya
AU - Hayashi, Yasuyuki
AU - Ikeuchi, Hisashi
AU - Tanaka, Hiroshi
AU - Shimazu, Takeshi
AU - Sugimoto, Hisashi
N1 - Funding Information:
Grants and Financial Support: this study was supported by Grant-in-Aid for University and Society Collaboration, Grant-in-Aid for Scientific research from the Ministry of Education, Science, Sports, and Culture, Japan (No. 11794023, 19390459), and Health and Labor Science Research Grant for Cardiovascular Diseases (14C-7), H16-Shinkin-02, Comprehensive Research on Cardiovascular Diseases, and Research on Medical Safety and Health Technology Assessment from the Japanese Ministry of Health, Labor and Welfare.
PY - 2008/10
Y1 - 2008/10
N2 - Background: The prognostic implications of conversion to ventricular fibrillation (VF) in out-of-hospital cardiac arrest (OHCA) patients with an initial non-shockable rhythm are unclear. Hypothesis: Among OHCA patients with an initial non-shockable rhythm, survival is better in individuals who subsequently develop VF and are defibrillated. Methods: Design: Utstein style population-based cohort study. Subjects: adults (age ≧ 18 years) with OHCA of presumed cardiac etiology and initial rhythm of pulseless electrical activity (PEA) or asystole treated by emergency medical services systems in Osaka, Japan from January 1, 2001 to December 31, 2005. Primary outcome measure was one-month neurologically favorable survival (CPC ≤ 2). Outcome of patients with subsequent VF (SHOCK group) was compared to that of patients with sustained non-shockable rhythm (NON-SHOCK group) using logistic regression to adjust for potential confounding variables. Results: Of 14,316 OHCA, 12,353 cases had PEA or asystole as the initial rhythm. Of these, 11,766 (95%) remained in a non-shockable rhythm throughout the resuscitation effort while 587 (5%) subsequently developed VF and were defibrillated. Neurologically favorable survival at one month was significantly better in the SHOCK group (6% versus 1%, p < 0.001). Subsequent VF remained a significant predictor (OR, 4.3; 95% CI, 2.8-6.7) of neurologically favorable survival after adjustment for potential confounders. Conclusions: Based on a large-scaled population-based cohort of OHCA, subsequent VF with defibrillation was associated with better outcomes among patients with an initial non-shockable rhythm.
AB - Background: The prognostic implications of conversion to ventricular fibrillation (VF) in out-of-hospital cardiac arrest (OHCA) patients with an initial non-shockable rhythm are unclear. Hypothesis: Among OHCA patients with an initial non-shockable rhythm, survival is better in individuals who subsequently develop VF and are defibrillated. Methods: Design: Utstein style population-based cohort study. Subjects: adults (age ≧ 18 years) with OHCA of presumed cardiac etiology and initial rhythm of pulseless electrical activity (PEA) or asystole treated by emergency medical services systems in Osaka, Japan from January 1, 2001 to December 31, 2005. Primary outcome measure was one-month neurologically favorable survival (CPC ≤ 2). Outcome of patients with subsequent VF (SHOCK group) was compared to that of patients with sustained non-shockable rhythm (NON-SHOCK group) using logistic regression to adjust for potential confounding variables. Results: Of 14,316 OHCA, 12,353 cases had PEA or asystole as the initial rhythm. Of these, 11,766 (95%) remained in a non-shockable rhythm throughout the resuscitation effort while 587 (5%) subsequently developed VF and were defibrillated. Neurologically favorable survival at one month was significantly better in the SHOCK group (6% versus 1%, p < 0.001). Subsequent VF remained a significant predictor (OR, 4.3; 95% CI, 2.8-6.7) of neurologically favorable survival after adjustment for potential confounders. Conclusions: Based on a large-scaled population-based cohort of OHCA, subsequent VF with defibrillation was associated with better outcomes among patients with an initial non-shockable rhythm.
KW - Asystole
KW - Cardiopulmonary resuscitation (CPR)
KW - Emergency medical services (EMS)
KW - Out-of-hospital Cardiac Arrest (OHCA)
KW - Pulseless electrical activity (PEA)
KW - Return of spontaneous circulation (ROSC)
KW - Ventricular fibrillation (VF)
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U2 - 10.1016/j.resuscitation.2008.05.017
DO - 10.1016/j.resuscitation.2008.05.017
M3 - Article
C2 - 18678438
AN - SCOPUS:51949096761
SN - 0300-9572
VL - 79
SP - 34
EP - 40
JO - Resuscitation
JF - Resuscitation
IS - 1
ER -