The association of the post-resuscitation on-scene interval and patient outcomes after out-of-hospital cardiac arrest
After resuscitation from out-of-hospital cardiac arrest (OHCA) by Emergency Medical Services (EMS), the amount of time that should be dedicated to pre-transport stabilization is unclear. We examined whether the time spent on-scene after return of spontaneous circulation (ROSC) was associated with pa...
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| Vydané v: | Resuscitation Ročník 188; s. 109753 |
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| Hlavní autori: | , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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Ireland
Elsevier B.V
01.07.2023
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| ISSN: | 0300-9572, 1873-1570, 1873-1570 |
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| Abstract | After resuscitation from out-of-hospital cardiac arrest (OHCA) by Emergency Medical Services (EMS), the amount of time that should be dedicated to pre-transport stabilization is unclear. We examined whether the time spent on-scene after return of spontaneous circulation (ROSC) was associated with patient outcomes.
We examined consecutive adult EMS-treated OHCAs from the British Columbia Cardiac Arrest registry (January 1/2019-June 1/2021) that had on-scene ROSC (sustained to scene departure). The primary outcome was favourable neurological outcome (Cerebral Performance Category ≤ 2) at hospital discharge; secondary outcomes were re-arrest during transport and hospital-discharge survival. Using adjusted logistic regression models, we estimated the association between the post-resuscitation on-scene interval (divided into quartiles) and outcomes.
Of 1653 cases, 611 (37%) survived to hospital discharge, and 523 (32%) had favourable neurological outcomes. The median post-resuscitation on-scene interval was 18.8 minutes (IQR:13.0–25.5). Compared to the first post-resuscitation on-scene interval quartile, neither the second (adjusted odds ratio [AOR] 1.19; 95% CI 0.72–1.98), third (AOR 1.10; 95% CI 0.67–1.81), nor fourth (AOR 1.54; 95% CI 0.93–2.56) quartiles were associated with favourable neurological outcomes; however, the fourth quartile was associated with a greater odds of hospital-discharge survival (AOR 1.73; 95% CI 1.05–2.85), and both the third (AOR 0.40; 95% CI 0.22–0.72) and fourth (AOR 0.44;95% CI 0.24–0.81) quartiles were associated with a lower odds of intra-transport re-arrest.
Among resuscitated OHCAs, increased post-resuscitation on-scene time was not associated with improved neurological outcomes, but was associated with improved survival to hospital discharge and decreased intra-transport re-arrest. |
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| AbstractList | After resuscitation from out-of-hospital cardiac arrest (OHCA) by Emergency Medical Services (EMS), the amount of time that should be dedicated to pre-transport stabilization is unclear. We examined whether the time spent on-scene after return of spontaneous circulation (ROSC) was associated with patient outcomes.
We examined consecutive adult EMS-treated OHCAs from the British Columbia Cardiac Arrest registry (January 1/2019-June 1/2021) that had on-scene ROSC (sustained to scene departure). The primary outcome was favourable neurological outcome (Cerebral Performance Category ≤ 2) at hospital discharge; secondary outcomes were re-arrest during transport and hospital-discharge survival. Using adjusted logistic regression models, we estimated the association between the post-resuscitation on-scene interval (divided into quartiles) and outcomes.
Of 1653 cases, 611 (37%) survived to hospital discharge, and 523 (32%) had favourable neurological outcomes. The median post-resuscitation on-scene interval was 18.8 minutes (IQR:13.0-25.5). Compared to the first post-resuscitation on-scene interval quartile, neither the second (adjusted odds ratio [AOR] 1.19; 95% CI 0.72-1.98), third (AOR 1.10; 95% CI 0.67-1.81), nor fourth (AOR 1.54; 95% CI 0.93-2.56) quartiles were associated with favourable neurological outcomes; however, the fourth quartile was associated with a greater odds of hospital-discharge survival (AOR 1.73; 95% CI 1.05-2.85), and both the third (AOR 0.40; 95% CI 0.22-0.72) and fourth (AOR 0.44;95% CI 0.24-0.81) quartiles were associated with a lower odds of intra-transport re-arrest.
Among resuscitated OHCAs, increased post-resuscitation on-scene time was not associated with improved neurological outcomes, but was associated with improved survival to hospital discharge and decreased intra-transport re-arrest. After resuscitation from out-of-hospital cardiac arrest (OHCA) by Emergency Medical Services (EMS), the amount of time that should be dedicated to pre-transport stabilization is unclear. We examined whether the time spent on-scene after return of spontaneous circulation (ROSC) was associated with patient outcomes.BACKGROUNDAfter resuscitation from out-of-hospital cardiac arrest (OHCA) by Emergency Medical Services (EMS), the amount of time that should be dedicated to pre-transport stabilization is unclear. We examined whether the time spent on-scene after return of spontaneous circulation (ROSC) was associated with patient outcomes.We examined consecutive adult EMS-treated OHCAs from the British Columbia Cardiac Arrest registry (January 1/2019-June 1/2021) that had on-scene ROSC (sustained to scene departure). The primary outcome was favourable neurological outcome (Cerebral Performance Category ≤ 2) at hospital discharge; secondary outcomes were re-arrest during transport and hospital-discharge survival. Using adjusted logistic regression models, we estimated the association between the post-resuscitation on-scene interval (divided into quartiles) and outcomes.METHODSWe examined consecutive adult EMS-treated OHCAs from the British Columbia Cardiac Arrest registry (January 1/2019-June 1/2021) that had on-scene ROSC (sustained to scene departure). The primary outcome was favourable neurological outcome (Cerebral Performance Category ≤ 2) at hospital discharge; secondary outcomes were re-arrest during transport and hospital-discharge survival. Using adjusted logistic regression models, we estimated the association between the post-resuscitation on-scene interval (divided into quartiles) and outcomes.Of 1653 cases, 611 (37%) survived to hospital discharge, and 523 (32%) had favourable neurological outcomes. The median post-resuscitation on-scene interval was 18.8 minutes (IQR:13.0-25.5). Compared to the first post-resuscitation on-scene interval quartile, neither the second (adjusted odds ratio [AOR] 1.19; 95% CI 0.72-1.98), third (AOR 1.10; 95% CI 0.67-1.81), nor fourth (AOR 1.54; 95% CI 0.93-2.56) quartiles were associated with favourable neurological outcomes; however, the fourth quartile was associated with a greater odds of hospital-discharge survival (AOR 1.73; 95% CI 1.05-2.85), and both the third (AOR 0.40; 95% CI 0.22-0.72) and fourth (AOR 0.44;95% CI 0.24-0.81) quartiles were associated with a lower odds of intra-transport re-arrest.RESULTSOf 1653 cases, 611 (37%) survived to hospital discharge, and 523 (32%) had favourable neurological outcomes. The median post-resuscitation on-scene interval was 18.8 minutes (IQR:13.0-25.5). Compared to the first post-resuscitation on-scene interval quartile, neither the second (adjusted odds ratio [AOR] 1.19; 95% CI 0.72-1.98), third (AOR 1.10; 95% CI 0.67-1.81), nor fourth (AOR 1.54; 95% CI 0.93-2.56) quartiles were associated with favourable neurological outcomes; however, the fourth quartile was associated with a greater odds of hospital-discharge survival (AOR 1.73; 95% CI 1.05-2.85), and both the third (AOR 0.40; 95% CI 0.22-0.72) and fourth (AOR 0.44;95% CI 0.24-0.81) quartiles were associated with a lower odds of intra-transport re-arrest.Among resuscitated OHCAs, increased post-resuscitation on-scene time was not associated with improved neurological outcomes, but was associated with improved survival to hospital discharge and decreased intra-transport re-arrest.CONCLUSIONAmong resuscitated OHCAs, increased post-resuscitation on-scene time was not associated with improved neurological outcomes, but was associated with improved survival to hospital discharge and decreased intra-transport re-arrest. |
| ArticleNumber | 109753 |
| Author | van Diepen, Sean Hutton, Jacob Yap, Justin Dodek, Peter Christenson, Jim Wall, Nechelle Fordyce, Christopher B. Asamoah-Boaheng, Michael Grunau, Brian Khan, Laiba Scheuermeyer, Frank Heidet, Matthieu |
| Author_xml | – sequence: 1 givenname: Laiba surname: Khan fullname: Khan, Laiba organization: British Columbia Resuscitation Research Collaborative, British Columbia, Canada – sequence: 2 givenname: Jacob surname: Hutton fullname: Hutton, Jacob organization: British Columbia Resuscitation Research Collaborative, British Columbia, Canada – sequence: 3 givenname: Justin surname: Yap fullname: Yap, Justin organization: British Columbia Resuscitation Research Collaborative, British Columbia, Canada – sequence: 4 givenname: Peter surname: Dodek fullname: Dodek, Peter organization: Faculty of Medicine, University of British Columbia, British Columbia, Canada – sequence: 5 givenname: Frank surname: Scheuermeyer fullname: Scheuermeyer, Frank organization: British Columbia Resuscitation Research Collaborative, British Columbia, Canada – sequence: 6 givenname: Michael surname: Asamoah-Boaheng fullname: Asamoah-Boaheng, Michael organization: British Columbia Resuscitation Research Collaborative, British Columbia, Canada – sequence: 7 givenname: Matthieu surname: Heidet fullname: Heidet, Matthieu organization: British Columbia Resuscitation Research Collaborative, British Columbia, Canada – sequence: 8 givenname: Nechelle surname: Wall fullname: Wall, Nechelle organization: British Columbia Resuscitation Research Collaborative, British Columbia, Canada – sequence: 9 givenname: Christopher B. surname: Fordyce fullname: Fordyce, Christopher B. organization: British Columbia Resuscitation Research Collaborative, British Columbia, Canada – sequence: 10 givenname: Sean surname: van Diepen fullname: van Diepen, Sean organization: British Columbia Resuscitation Research Collaborative, British Columbia, Canada – sequence: 11 givenname: Jim surname: Christenson fullname: Christenson, Jim organization: British Columbia Resuscitation Research Collaborative, British Columbia, Canada – sequence: 12 givenname: Brian orcidid: 0000-0003-4103-1383 surname: Grunau fullname: Grunau, Brian email: Brian.Grunau@ubc.ca organization: British Columbia Resuscitation Research Collaborative, British Columbia, Canada |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36842676$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1016_j_ajem_2025_08_038 crossref_primary_10_1016_j_resuscitation_2023_109819 crossref_primary_10_1055_a_2171_7223 crossref_primary_10_1016_j_resuscitation_2024_110349 crossref_primary_10_3390_jcm14186645 crossref_primary_10_1055_a_2040_9978 crossref_primary_10_1016_j_resplu_2024_100691 crossref_primary_10_1272_jnms_JNMS_2025_92_207 |
| Cites_doi | 10.1016/j.resuscitation.2014.10.011 10.1161/CIR.0000000000000918 10.1016/j.resuscitation.2020.05.047 10.1161/01.CIR.0000147236.85306.15 10.3109/10903127.2016.1149652 10.1016/j.resuscitation.2021.09.004 10.1161/CIRCOUTCOMES.115.001864 10.1161/CIR.0000000000000259 10.1186/s12872-020-01571-5 10.1001/jama.300.12.1423 10.1080/10903127.2020.1754979 10.1186/1471-227X-9-14 10.1016/j.resuscitation.2010.04.012 10.1016/j.resuscitation.2022.09.018 10.1161/CIRCOUTCOMES.117.003561 10.1016/j.jbi.2019.103208 10.1016/j.resuscitation.2018.05.028 10.1007/978-3-319-19425-7 10.1016/j.resuscitation.2018.01.049 10.1016/j.resuscitation.2013.12.005 10.3109/10903127.2010.519820 10.1161/CIR.0000000000000950 10.1016/j.resuscitation.2014.07.010 10.1016/j.resuscitation.2018.12.003 10.1016/j.resuscitation.2006.02.002 10.1016/j.resuscitation.2008.05.006 10.1080/10903127.2020.1752868 10.1016/j.resuscitation.2005.08.018 10.1016/j.annemergmed.2008.11.020 |
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