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Pulseless electrical activity is associated with improved survival in out-of-hospital cardiac arrest with initial non-shockable rhythm

Bergström, Mattias LU ; Schmidbauer, Simon LU orcid ; Herlitz, Johan ; Rawshani, Araz and Friberg, Hans LU (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.

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author
; ; ; and
organization
publishing date
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
  • scopus:85055332105
  • pmid:30352246
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
2024-03-02 11:43:00
@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}},
}