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Association between the number of prehospital defibrillation attempts and a sustained return of spontaneous circulation: a retrospective, multicentre, registry-based study

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dc.contributor.author박인철-
dc.date.accessioned2023-08-09T06:42:35Z-
dc.date.available2023-08-09T06:42:35Z-
dc.date.issued2023-06-
dc.identifier.issn1472-0205-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/195939-
dc.description.abstractBackground: Currently, there is no consensus on the number of defibrillation attempts that should be made before transfer to a hospital in patients with out-of-hospital cardiac arrest (OHCA). This study aimed to evaluate the association between the number of defibrillations and a sustained prehospital return of spontaneous circulation (ROSC). Methods: A retrospective analysis of a multicentre, prospectively collected, registry-based study in Republic of Korea was conducted for OHCA patients with prehospital defibrillation. The primary outcome was sustained prehospital ROSC, and the secondary outcome was a good neurological outcome at hospital discharge, defined as Cerebral Performance Category score 1 or 2. Cumulative incidence of sustained prehospital ROSC and good neurological outcome according to number of defibrillations were examined. Multivariable logistic regression analysis was used to examine whether the number of defibrillations was independently associated with the outcomes. Results: Excluding 172 patients with missing data, a total of 1983 OHCA patients who received prehospital defibrillation were included. The median time from arrest to first defibrillation was 10 (IQR 7-15) min. The numbers of patients with sustained prehospital ROSC and good neurological outcome were 738 (37%) and 549 (28%), respectively. Sustained ROSC rates decreased as the number of defibrillation attempts increased from the first to the sixth (16%, 9%, 5%, 3%, 2% and 1%, respectively). The cumulative sustained ROSC rate, and good neurological outcome rate from initial defibrillation to sixth defibrillation were 16%, 25%, 30%, 34%, 36%, 36% and 11%, 18%, 22%, 25%, 26%, 27%, respectively. With adjustment for clinical characteristics and time to defibrillation, a higher number of defibrillations was independently associated with a lower chance of a sustained ROSC (OR 0.81, 95% CI 0.76 to 0.86) and a lower chance of good neurological outcome (OR 0.86, 95% CI 0.80 to 0.92). Conclusions: We observed no significant increase in ROSC after five defibrillations, and no absolute increase in ROSC after seven defibrillations. These data provide a starting point for determination of the optimal defibrillation strategy prior to consideration for prehospital extracorporeal cardiopulmonary resuscitation (ECPR) or conveyance to a hospital with an ECPR capability.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherBMJ Pub. Group-
dc.relation.isPartOfEMERGENCY MEDICINE JOURNAL-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHCardiopulmonary Resuscitation*-
dc.subject.MESHEmergency Medical Services*-
dc.subject.MESHHumans-
dc.subject.MESHOut-of-Hospital Cardiac Arrest*-
dc.subject.MESHRegistries-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHReturn of Spontaneous Circulation-
dc.titleAssociation between the number of prehospital defibrillation attempts and a sustained return of spontaneous circulation: a retrospective, multicentre, registry-based study-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Emergency Medicine (응급의학교실)-
dc.contributor.googleauthorByuk Sung Ko-
dc.contributor.googleauthorYoun-Jung Kim-
dc.contributor.googleauthorKap Su Han-
dc.contributor.googleauthorYou Hwan Jo-
dc.contributor.googleauthorJongHwan Shin-
dc.contributor.googleauthorIncheol Park-
dc.contributor.googleauthorHyunggoo Kang-
dc.contributor.googleauthorTae Ho Lim-
dc.contributor.googleauthorS O Hwang-
dc.contributor.googleauthorWon Young Kim-
dc.identifier.doi10.1136/emermed-2021-212091-
dc.contributor.localIdA01628-
dc.relation.journalcodeJ00766-
dc.identifier.eissn1472-0213-
dc.identifier.pmid37024298-
dc.identifier.urlhttps://emj.bmj.com/content/40/6/424.long-
dc.subject.keywordemergency department-
dc.subject.keywordresuscitation-
dc.contributor.alternativeNamePark, In Cheol-
dc.contributor.affiliatedAuthor박인철-
dc.citation.volume40-
dc.citation.number6-
dc.citation.startPage424-
dc.citation.endPage430-
dc.identifier.bibliographicCitationEMERGENCY MEDICINE JOURNAL, Vol.40(6) : 424-430, 2023-06-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers

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