TY - JOUR
T1 - Association between shockable rhythm conversion and outcomes in patients with out-of-hospital cardiac arrest and initial non-shockable rhythm, according to the cause of cardiac arrest
AU - Han, Kap Su
AU - Lee, Sung Woo
AU - Lee, Eui Jung
AU - Kwak, Moon Hwan
AU - Kim, Su Jin
N1 - Funding Information:
The study was funded by the National Research Foundation of Korea, grant no. 2017RIA2B1005037. This work was also supported by the grant funded by Korea University (#K1625501, #K1813011). Su Jin Kim received funding from the National Research Foundation of Korea and from Korea University. The funding sources had no role in the study design, data collection, data analysis, data interpretation, or writing of the report.
Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/9
Y1 - 2019/9
N2 - Objective: Conversion to shockable rhythm from an initial non-shockable rhythm is associated with good neurologic prognoses in patients with out-of-hospital cardiac arrest (OHCA). We aimed to investigate whether conversion to shockable rhythm has an association with good neurologic outcomes, according to the etiology of cardiac arrest. Methods: We conducted a nationwide, population-based, cohort study using the OHCA data from the Korea Centers for Disease Control and Prevention database in 2012–2016. We included patients with OHCA and an initial non-shockable rhythm. The primary outcome was good neurologic outcome at discharge, etiologies of arrest were categorized to medical, non-medical cause. We analyzed the effect of conversion to a shockable rhythm on outcome according to causes of cardiac arrest using multiple regression analysis. Results: Of 114,628 patients with an initial non-shockable rhythm, 25,042 (21.8%) experienced conversion to a shockable rhythm; 83,437 (72.8%) had medical causes and 31,191(27.2%) had non-medical causes. In all patients with OHCA and initial non-shockable rhythm, adjusted odds ratio (OR) of conversion for good neurologic outcome was 2.051 (95% confidence interval [CI] 1.181–2.297). The medical cause group showed an adjusted OR 1.789 (95% CI 1.586–2.019) of conversion for good neurologic outcome. In non-medical cause group, the adjusted OR of conversion was 0.644 (95% CI 0.372–1.114). Conclusion: Conversion to shockable rhythm had an association with good neurologic outcome in patients with OHCA with initial non-shockable rhythms, especially due to cardiac cause. However, rhythm conversion was not associated with better outcome in patients with non-medical causes.
AB - Objective: Conversion to shockable rhythm from an initial non-shockable rhythm is associated with good neurologic prognoses in patients with out-of-hospital cardiac arrest (OHCA). We aimed to investigate whether conversion to shockable rhythm has an association with good neurologic outcomes, according to the etiology of cardiac arrest. Methods: We conducted a nationwide, population-based, cohort study using the OHCA data from the Korea Centers for Disease Control and Prevention database in 2012–2016. We included patients with OHCA and an initial non-shockable rhythm. The primary outcome was good neurologic outcome at discharge, etiologies of arrest were categorized to medical, non-medical cause. We analyzed the effect of conversion to a shockable rhythm on outcome according to causes of cardiac arrest using multiple regression analysis. Results: Of 114,628 patients with an initial non-shockable rhythm, 25,042 (21.8%) experienced conversion to a shockable rhythm; 83,437 (72.8%) had medical causes and 31,191(27.2%) had non-medical causes. In all patients with OHCA and initial non-shockable rhythm, adjusted odds ratio (OR) of conversion for good neurologic outcome was 2.051 (95% confidence interval [CI] 1.181–2.297). The medical cause group showed an adjusted OR 1.789 (95% CI 1.586–2.019) of conversion for good neurologic outcome. In non-medical cause group, the adjusted OR of conversion was 0.644 (95% CI 0.372–1.114). Conclusion: Conversion to shockable rhythm had an association with good neurologic outcome in patients with OHCA with initial non-shockable rhythms, especially due to cardiac cause. However, rhythm conversion was not associated with better outcome in patients with non-medical causes.
UR - http://www.scopus.com/inward/record.url?scp=85070533285&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2019.07.025
DO - 10.1016/j.resuscitation.2019.07.025
M3 - Article
C2 - 31377392
AN - SCOPUS:85070533285
SN - 0300-9572
VL - 142
SP - 144
EP - 152
JO - Resuscitation
JF - Resuscitation
ER -