Association Between Defibrillation Using LIFEPAK 15 or ZOLL X Series and Survival Outcomes in Out‐of‐Hospital Cardiac Arrest: A Nationwide Cohort Study
Background Defibrillation is essential for achieving return of spontaneous circulation (ROSC) following out‐of‐hospital cardiac arrest (OHCA) with shockable rhythms. This study aimed to investigate if the type of defibrillator used was associated with ROSC in OHCA. Methods and Results This study inc...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.033913 |
| _version_ | 1827298179450667008 |
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| author | Carsten Meilandt Mette Qvortrup Morten Thingemann Bøtker Fredrik Folke Lars Borup Helle Collatz Christensen Louise Milling Kasper G. Lauridsen Bo Løfgren |
| author_facet | Carsten Meilandt Mette Qvortrup Morten Thingemann Bøtker Fredrik Folke Lars Borup Helle Collatz Christensen Louise Milling Kasper G. Lauridsen Bo Løfgren |
| author_sort | Carsten Meilandt |
| collection | DOAJ |
| description | Background Defibrillation is essential for achieving return of spontaneous circulation (ROSC) following out‐of‐hospital cardiac arrest (OHCA) with shockable rhythms. This study aimed to investigate if the type of defibrillator used was associated with ROSC in OHCA. Methods and Results This study included adult patients with OHCA from the Danish Cardiac Arrest Registry from 2016 to 2021 with at least 1 defibrillation by the emergency medical services. We used multivariable logistic regression and a difference‐in‐difference analysis, including all patients with or without emergency medical services shock to assess the causal inference of using the different defibrillator models (LIFEPAK or ZOLL) for OHCA defibrillation. Among 6516 patients, 77% were male, the median age (quartile 1; quartile 3) was 70 (59; 79), and 57% achieved ROSC. In total, 5514 patients (85%) were defibrillated using LIFEPAK (ROSC: 56%) and 1002 patients (15%) were defibrillated using ZOLL (ROSC: 63%). Patients defibrillated using ZOLL had an increased adjusted odds ratio (aOR) for ROSC compared with LIFEPAK (aOR, 1.22 [95% CI, 1.04–1.43]). There was no significant difference in 30‐day mortality (aOR, 1.11 [95% CI, 0.95–1.30]). Patients without emergency medical services defibrillation, but treated by ZOLL‐equipped emergency medical services, had a nonsignificant aOR for ROSC compared with LIFEPAK (aOR, 1.10 [95% CI, 0.99–1.23]) and the difference‐in‐difference analysis was not statistically significant (OR, 1.10 [95% CI, 0.91–1.34]). Conclusions Defibrillation using ZOLL X Series was associated with increased odds for ROSC compared with defibrillation using LIFEPAK 15 for patients with OHCA. However, a difference‐in‐difference analysis suggested that other factors may be responsible for the observed association. |
| first_indexed | 2024-04-24T15:09:44Z |
| format | Article |
| id | doaj.art-8d5e5ba9ef8e47fc8937565dc9fbe7da |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-24T15:09:44Z |
| publishDate | 2024-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-8d5e5ba9ef8e47fc8937565dc9fbe7da2024-04-02T11:49:51ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-04-0113710.1161/JAHA.123.033913Association Between Defibrillation Using LIFEPAK 15 or ZOLL X Series and Survival Outcomes in Out‐of‐Hospital Cardiac Arrest: A Nationwide Cohort StudyCarsten Meilandt0Mette Qvortrup1Morten Thingemann Bøtker2Fredrik Folke3Lars Borup4Helle Collatz Christensen5Louise Milling6Kasper G. Lauridsen7Bo Løfgren8Prehospital Emergency Medical Services, Central Denmark Region Aarhus DenmarkDepartment of Cardiology Viborg Regional Hospital Viborg DenmarkPrehospital Emergency Medical Services, Central Denmark Region Aarhus DenmarkCopenhagen Emergency Medical Services, Capital Region of Denmark Copenhagen DenmarkPrehospital Emergency Medical Services, North Denmark Region Aalborg DenmarkPrehospital Emergency Medical Services, Region Zealand Næstved DenmarkThe Prehospital Research Unit, Region of Southern Denmark Odense DenmarkResearch Center for Emergency Medicine Aarhus University Aarhus DenmarkResearch Center for Emergency Medicine Aarhus University Aarhus DenmarkBackground Defibrillation is essential for achieving return of spontaneous circulation (ROSC) following out‐of‐hospital cardiac arrest (OHCA) with shockable rhythms. This study aimed to investigate if the type of defibrillator used was associated with ROSC in OHCA. Methods and Results This study included adult patients with OHCA from the Danish Cardiac Arrest Registry from 2016 to 2021 with at least 1 defibrillation by the emergency medical services. We used multivariable logistic regression and a difference‐in‐difference analysis, including all patients with or without emergency medical services shock to assess the causal inference of using the different defibrillator models (LIFEPAK or ZOLL) for OHCA defibrillation. Among 6516 patients, 77% were male, the median age (quartile 1; quartile 3) was 70 (59; 79), and 57% achieved ROSC. In total, 5514 patients (85%) were defibrillated using LIFEPAK (ROSC: 56%) and 1002 patients (15%) were defibrillated using ZOLL (ROSC: 63%). Patients defibrillated using ZOLL had an increased adjusted odds ratio (aOR) for ROSC compared with LIFEPAK (aOR, 1.22 [95% CI, 1.04–1.43]). There was no significant difference in 30‐day mortality (aOR, 1.11 [95% CI, 0.95–1.30]). Patients without emergency medical services defibrillation, but treated by ZOLL‐equipped emergency medical services, had a nonsignificant aOR for ROSC compared with LIFEPAK (aOR, 1.10 [95% CI, 0.99–1.23]) and the difference‐in‐difference analysis was not statistically significant (OR, 1.10 [95% CI, 0.91–1.34]). Conclusions Defibrillation using ZOLL X Series was associated with increased odds for ROSC compared with defibrillation using LIFEPAK 15 for patients with OHCA. However, a difference‐in‐difference analysis suggested that other factors may be responsible for the observed association.https://www.ahajournals.org/doi/10.1161/JAHA.123.033913cardiopulmonary resuscitationdefibrillationemergency medical servicesout‐of‐hospital cardiac arrestshockable rhythm |
| spellingShingle | Carsten Meilandt Mette Qvortrup Morten Thingemann Bøtker Fredrik Folke Lars Borup Helle Collatz Christensen Louise Milling Kasper G. Lauridsen Bo Løfgren Association Between Defibrillation Using LIFEPAK 15 or ZOLL X Series and Survival Outcomes in Out‐of‐Hospital Cardiac Arrest: A Nationwide Cohort Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiopulmonary resuscitation defibrillation emergency medical services out‐of‐hospital cardiac arrest shockable rhythm |
| title | Association Between Defibrillation Using LIFEPAK 15 or ZOLL X Series and Survival Outcomes in Out‐of‐Hospital Cardiac Arrest: A Nationwide Cohort Study |
| title_full | Association Between Defibrillation Using LIFEPAK 15 or ZOLL X Series and Survival Outcomes in Out‐of‐Hospital Cardiac Arrest: A Nationwide Cohort Study |
| title_fullStr | Association Between Defibrillation Using LIFEPAK 15 or ZOLL X Series and Survival Outcomes in Out‐of‐Hospital Cardiac Arrest: A Nationwide Cohort Study |
| title_full_unstemmed | Association Between Defibrillation Using LIFEPAK 15 or ZOLL X Series and Survival Outcomes in Out‐of‐Hospital Cardiac Arrest: A Nationwide Cohort Study |
| title_short | Association Between Defibrillation Using LIFEPAK 15 or ZOLL X Series and Survival Outcomes in Out‐of‐Hospital Cardiac Arrest: A Nationwide Cohort Study |
| title_sort | association between defibrillation using lifepak 15 or zoll x series and survival outcomes in out of hospital cardiac arrest a nationwide cohort study |
| topic | cardiopulmonary resuscitation defibrillation emergency medical services out‐of‐hospital cardiac arrest shockable rhythm |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.033913 |
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