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• W2462712670 abstract "Context There are numerous potential benefits to better understanding the prognosis of victims of initially non-shockable cardiac arrests including changes to future resuscitation care guidelines. Objective To evaluate whether out-of-hospital cardiac arrest outcomes for patients whose initial arrest rhythm is nonshockable improve or worsen with subsequent conversion to shockable rhythms. Design, Setting, and Patients This study is a cohort design secondary analysis of the prospectively-collected Cardiac Arrest Epidemiologic Registry (Epistry) organized by the Resuscitation Outcomes Consortium (ROC) of all out-of-hospital cardiac arrests at eight North American sites (6 US and 2 Canadian) between December 1, 2005, to May 31, 2007, followed through hospital discharge. The investigational cohort is identified as all EMS-treated adult (18 and older) cardiac arrest patients who presented in non-shockable rhythms (Pulseless Electrical Activity, Asystole, or Automated External Defibrillator non-shockable) and were treated by emergency medical services (EMS) personnel and had a non-traumatic cause of arrest. Main Outcome Measures Survival to hospital discharge. Methods Simultaneous analysis of multiply-imputed and complete-case datasets by logistic regression. Multiple imputation was used to permit analysis of all cases including cases with incomplete ascertainment of one or more covariates. Results A total of 6,662 adult atraumatic cardiac arrest cases found in non-shockable rhythmsmet our inclusion criteria and survival outcomes were known for 6,593 (98.96%) cases. Analysis of these data reveal survival to discharge in 2.69% of patients. In patients who later converted to shockable rhythms survival was 2.72% and in those who never converted to shockable rhythms survival was 2.68%, a statistically insignificant difference between these groups (two-tailed z-test, p = 0.9555). These results were similar after controlling for a set of potential confounders which were selected a priori to coincide with earlier research. Conclusion The results of this research do not agree with several previous studies which found that out-of-hospital cardiac arrest survival differs when non-shockable rhythms convert to shockable rhythms during the course of treatment nor do they agree with studies which found the opposite – that conversion to shockable rhythms was detrimental to patient survival. Our results suggest that cardiac arrest patients fare similarly in terms of survival to hospital discharge regardless of converting to shockable rhythms at subsequent rhythm assessment." @default.
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• W2462712670 date "2011-01-01" @default.
• W2462712670 modified "2023-09-23" @default.
• W2462712670 title "Secondary shockable rhythms : prognosis in cardiac arrests with initial asystole or pulseless electrical activity and subsequent shockable rhythms" @default.
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