1. Prognostic implications of conversion from nonshockable to shockable rhythms in out-of-hospital cardiac arrest
- Author
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Tetsuo Maeda, Yumiko Nakatsu-Goto, and Yoshikazu Goto
- Subjects
Male ,medicine.medical_specialty ,Resuscitation ,Emergency Medical Services ,Epinephrine ,Defibrillation ,medicine.medical_treatment ,Electric Countershock ,Critical Care and Intensive Care Medicine ,Japan ,Heart Rate ,Internal medicine ,medicine ,Emergency medical services ,Humans ,Cardiopulmonary resuscitation ,Prospective Studies ,Sympathomimetics ,Prospective cohort study ,Aged ,Aged, 80 and over ,business.industry ,Research ,Odds ratio ,Middle Aged ,Prognosis ,Confidence interval ,Cardiopulmonary Resuscitation ,Logistic Models ,Treatment Outcome ,Cohort ,Cardiology ,Female ,business ,Out-of-Hospital Cardiac Arrest - Abstract
Introduction The prognostic significance of conversion from nonshockable to shockable rhythms in patients with initial nonshockable rhythms who experience out-of-hospital cardiac arrest (OHCA) remains unclear. We hypothesized that the neurological outcomes in those patients would improve with subsequent shock delivery following conversion to shockable rhythms and that the time from initiation of cardiopulmonary resuscitation by emergency medical services personnel to the first defibrillation (shock delivery time) would influence those outcomes. Methods We analyzed the data of 569,937 OHCA adults with initial nonshockable rhythms. The data were collected in a nationwide Utstein-style Japanese database between 2005 and 2010. Patients were divided into subsequently shocked (n =21,944) and subsequently not-shocked (n =547,993) cohorts. The primary study endpoint was 1-month favorable neurological outcome (Cerebral Performance Categories scale, category 1 or 2). Results In the subsequently shocked cohort, the ratio of 1-month favorable neurological outcome was significantly higher than that in the subsequently not-shocked cohort (1.79% versus 0.60%, P
- Published
- 2014