Pulseless electrical activity is associated with improved survival in out-of-hospital cardiac arrest with initial non-shockable rhythm
(2018) In Resuscitation 133. p.147-152- Abstract
Objective: To describe the prevalence, baseline characteristics and factors associated with survival in out-of-hospital cardiac arrest (OHCA) with initial non-shockable rhythm sub-grouped into pulseless electrical activity (PEA) and asystole as presenting rhythm. Methods: The Swedish Registry of Cardiopulmonary Resuscitation is a prospectively recorded nationwide registry of modified Utstein parameters, including all patients with attempted resuscitation after OHCA. Data between 1990–2016 were analyzed. Results: After exclusions, the study population consisted of 48,707 patients presenting with either PEA or asystole. The proportion of PEA increased from 12% to 22% during the study period with a fivefold increase in 30-day survival... (More)
Objective: To describe the prevalence, baseline characteristics and factors associated with survival in out-of-hospital cardiac arrest (OHCA) with initial non-shockable rhythm sub-grouped into pulseless electrical activity (PEA) and asystole as presenting rhythm. Methods: The Swedish Registry of Cardiopulmonary Resuscitation is a prospectively recorded nationwide registry of modified Utstein parameters, including all patients with attempted resuscitation after OHCA. Data between 1990–2016 were analyzed. Results: After exclusions, the study population consisted of 48,707 patients presenting with either PEA or asystole. The proportion of PEA increased from 12% to 22% during the study period with a fivefold increase in 30-day survival reaching 4.9%. Survival in asystole showed a modest increase from 0.6% to 1.3%. In the multivariable analysis, PEA was independently associated with survival at 30 days (OR 1.54, 95% CI 1.26–1.88). Conclusion: Between 1990 and 2016, the proportion of PEA as the first recorded rhythm doubled with a five-fold increase in 30-day survival, while survival among patients with asystole remained at low levels. PEA and asystole should be considered separate entities in clinical decision-making and be reported separately in observational studies and clinical trials.
(Less)
- author
- Bergström, Mattias LU ; Schmidbauer, Simon LU ; Herlitz, Johan ; Rawshani, Araz and Friberg, Hans LU
- organization
- publishing date
- 2018
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Asystole, Cardiac arrest, Non-shockable rhythm, Out-of-hospital cardiac arrest, Outcome, Pulseless electrical activity
- in
- Resuscitation
- volume
- 133
- pages
- 6 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:30352246
- scopus:85055332105
- ISSN
- 0300-9572
- DOI
- 10.1016/j.resuscitation.2018.10.018
- language
- English
- LU publication?
- yes
- id
- d34fa4b6-3ab0-4ccf-8174-cd87e2b02a22
- date added to LUP
- 2018-11-14 09:58:43
- date last changed
- 2024-03-18 18:56:29
@article{d34fa4b6-3ab0-4ccf-8174-cd87e2b02a22, abstract = {{<p>Objective: To describe the prevalence, baseline characteristics and factors associated with survival in out-of-hospital cardiac arrest (OHCA) with initial non-shockable rhythm sub-grouped into pulseless electrical activity (PEA) and asystole as presenting rhythm. Methods: The Swedish Registry of Cardiopulmonary Resuscitation is a prospectively recorded nationwide registry of modified Utstein parameters, including all patients with attempted resuscitation after OHCA. Data between 1990–2016 were analyzed. Results: After exclusions, the study population consisted of 48,707 patients presenting with either PEA or asystole. The proportion of PEA increased from 12% to 22% during the study period with a fivefold increase in 30-day survival reaching 4.9%. Survival in asystole showed a modest increase from 0.6% to 1.3%. In the multivariable analysis, PEA was independently associated with survival at 30 days (OR 1.54, 95% CI 1.26–1.88). Conclusion: Between 1990 and 2016, the proportion of PEA as the first recorded rhythm doubled with a five-fold increase in 30-day survival, while survival among patients with asystole remained at low levels. PEA and asystole should be considered separate entities in clinical decision-making and be reported separately in observational studies and clinical trials.</p>}}, author = {{Bergström, Mattias and Schmidbauer, Simon and Herlitz, Johan and Rawshani, Araz and Friberg, Hans}}, issn = {{0300-9572}}, keywords = {{Asystole; Cardiac arrest; Non-shockable rhythm; Out-of-hospital cardiac arrest; Outcome; Pulseless electrical activity}}, language = {{eng}}, pages = {{147--152}}, publisher = {{Elsevier}}, series = {{Resuscitation}}, title = {{Pulseless electrical activity is associated with improved survival in out-of-hospital cardiac arrest with initial non-shockable rhythm}}, url = {{http://dx.doi.org/10.1016/j.resuscitation.2018.10.018}}, doi = {{10.1016/j.resuscitation.2018.10.018}}, volume = {{133}}, year = {{2018}}, }