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

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Bibtex

@article{d34fa4b63ab04ccf8174cd87e2b02a22,
title = "Pulseless electrical activity is associated with improved survival in out-of-hospital cardiac arrest with initial non-shockable rhythm",
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 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.",
keywords = "Asystole, Cardiac arrest, Non-shockable rhythm, Out-of-hospital cardiac arrest, Outcome, Pulseless electrical activity",
author = "Mattias Bergstr{\"o}m and Simon Schmidbauer and Johan Herlitz and Araz Rawshani and Hans Friberg",
year = "2018",
doi = "10.1016/j.resuscitation.2018.10.018",
language = "English",
volume = "133",
pages = "147--152",
journal = "Resuscitation",
issn = "1873-1570",
publisher = "Elsevier",

}