Impact of defibrillation with automated external defibrillator by bystander before defibrillation by emergency medical system personnel on neurological outcome of out-of-hospital cardiac arrest with non-cardiac etiology
Aim of the study: Although defibrillation using automated external defibrillator (AED) by bystander prior to emergency medical system (EMS) arrival was associated with favorable outcomes in out-of-hospital cardiac arrest (OHCA) of cardiac cause, whether it improves outcomes of OHCA due to non-cardia...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-03-01
|
| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520423000061 |
| _version_ | 1797894410646585344 |
|---|---|
| author | Akira Komori Hiroki Iriyama Toshikazu Abe |
| author_facet | Akira Komori Hiroki Iriyama Toshikazu Abe |
| author_sort | Akira Komori |
| collection | DOAJ |
| description | Aim of the study: Although defibrillation using automated external defibrillator (AED) by bystander prior to emergency medical system (EMS) arrival was associated with favorable outcomes in out-of-hospital cardiac arrest (OHCA) of cardiac cause, whether it improves outcomes of OHCA due to non-cardiac cause is not clear. We aimed to investigate the impact of defibrillation with AED by bystander before defibrillation by EMS personnel on the outcomes of OHCA of presumed non-cardiac cause. Methods: This was a retrospective cohort study using the All-Japan Utstein registry (reference period: 2013 to 2017). We included adult patients with OHCA of presumed non-cardiac cause, who had initial shockable rhythm, and who received witnessed arrest bystander cardiopulmonary resuscitation (CPR). Exposure variable was defibrillation with AED by bystander in comparison with initial defibrillation by EMS. Logistic regression analyses were conducted to assess the association between bystander AED shock and favorable neurological outcome (Cerebral Performance Category scale 1 or 2) at one month. Results: Among the 1,053 patients included for analysis, 57 (5.4%) received bystander AED shock. There was no statistically significant difference in the rate of favorable neurological outcome at one month between groups [9 (15.8%) vs 109 (10.9%), p = 0.26]. Logistic regression analysis adjusted for characteristics, intervention, and time course of CPR showed no association between bystander AED shock and favorable neurological outcome [OR (95% CI): 1.63 (0.70–3.77), p = 0.25]. Conclusion: In this study, defibrillation with AED by bystander before defibrillation by EMS personnel was not associated with the favorable outcomes of OHCA of presumed non-cardiac cause. |
| first_indexed | 2024-04-10T07:08:36Z |
| format | Article |
| id | doaj.art-97ae1e4d12ed443482fc464f6662bcca |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-04-10T07:08:36Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-97ae1e4d12ed443482fc464f6662bcca2023-02-27T04:07:33ZengElsevierResuscitation Plus2666-52042023-03-0113100363Impact of defibrillation with automated external defibrillator by bystander before defibrillation by emergency medical system personnel on neurological outcome of out-of-hospital cardiac arrest with non-cardiac etiologyAkira Komori0Hiroki Iriyama1Toshikazu Abe2Department of Emergency and Critical Care Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan; Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan; Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan; Corresponding author at: Department of Emergency and Critical Care Medicine, Tsukuba Memorial Hospital, 1187-299, Kaname, Tsukuba, Ibaraki 300-2622, Japan.Department of Emergency and Critical Care Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan; Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan; Health Services Research and Development Center, University of Tsukuba, Tsukuba, JapanDepartment of Emergency and Critical Care Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan; Health Services Research and Development Center, University of Tsukuba, Tsukuba, JapanAim of the study: Although defibrillation using automated external defibrillator (AED) by bystander prior to emergency medical system (EMS) arrival was associated with favorable outcomes in out-of-hospital cardiac arrest (OHCA) of cardiac cause, whether it improves outcomes of OHCA due to non-cardiac cause is not clear. We aimed to investigate the impact of defibrillation with AED by bystander before defibrillation by EMS personnel on the outcomes of OHCA of presumed non-cardiac cause. Methods: This was a retrospective cohort study using the All-Japan Utstein registry (reference period: 2013 to 2017). We included adult patients with OHCA of presumed non-cardiac cause, who had initial shockable rhythm, and who received witnessed arrest bystander cardiopulmonary resuscitation (CPR). Exposure variable was defibrillation with AED by bystander in comparison with initial defibrillation by EMS. Logistic regression analyses were conducted to assess the association between bystander AED shock and favorable neurological outcome (Cerebral Performance Category scale 1 or 2) at one month. Results: Among the 1,053 patients included for analysis, 57 (5.4%) received bystander AED shock. There was no statistically significant difference in the rate of favorable neurological outcome at one month between groups [9 (15.8%) vs 109 (10.9%), p = 0.26]. Logistic regression analysis adjusted for characteristics, intervention, and time course of CPR showed no association between bystander AED shock and favorable neurological outcome [OR (95% CI): 1.63 (0.70–3.77), p = 0.25]. Conclusion: In this study, defibrillation with AED by bystander before defibrillation by EMS personnel was not associated with the favorable outcomes of OHCA of presumed non-cardiac cause.http://www.sciencedirect.com/science/article/pii/S2666520423000061Out-of-hospital cardiac arrestAutomated external defibrillatorDefibrillationNon-cardiac causeFavorable neurological outcome |
| spellingShingle | Akira Komori Hiroki Iriyama Toshikazu Abe Impact of defibrillation with automated external defibrillator by bystander before defibrillation by emergency medical system personnel on neurological outcome of out-of-hospital cardiac arrest with non-cardiac etiology Resuscitation Plus Out-of-hospital cardiac arrest Automated external defibrillator Defibrillation Non-cardiac cause Favorable neurological outcome |
| title | Impact of defibrillation with automated external defibrillator by bystander before defibrillation by emergency medical system personnel on neurological outcome of out-of-hospital cardiac arrest with non-cardiac etiology |
| title_full | Impact of defibrillation with automated external defibrillator by bystander before defibrillation by emergency medical system personnel on neurological outcome of out-of-hospital cardiac arrest with non-cardiac etiology |
| title_fullStr | Impact of defibrillation with automated external defibrillator by bystander before defibrillation by emergency medical system personnel on neurological outcome of out-of-hospital cardiac arrest with non-cardiac etiology |
| title_full_unstemmed | Impact of defibrillation with automated external defibrillator by bystander before defibrillation by emergency medical system personnel on neurological outcome of out-of-hospital cardiac arrest with non-cardiac etiology |
| title_short | Impact of defibrillation with automated external defibrillator by bystander before defibrillation by emergency medical system personnel on neurological outcome of out-of-hospital cardiac arrest with non-cardiac etiology |
| title_sort | impact of defibrillation with automated external defibrillator by bystander before defibrillation by emergency medical system personnel on neurological outcome of out of hospital cardiac arrest with non cardiac etiology |
| topic | Out-of-hospital cardiac arrest Automated external defibrillator Defibrillation Non-cardiac cause Favorable neurological outcome |
| url | http://www.sciencedirect.com/science/article/pii/S2666520423000061 |
| work_keys_str_mv | AT akirakomori impactofdefibrillationwithautomatedexternaldefibrillatorbybystanderbeforedefibrillationbyemergencymedicalsystempersonnelonneurologicaloutcomeofoutofhospitalcardiacarrestwithnoncardiacetiology AT hirokiiriyama impactofdefibrillationwithautomatedexternaldefibrillatorbybystanderbeforedefibrillationbyemergencymedicalsystempersonnelonneurologicaloutcomeofoutofhospitalcardiacarrestwithnoncardiacetiology AT toshikazuabe impactofdefibrillationwithautomatedexternaldefibrillatorbybystanderbeforedefibrillationbyemergencymedicalsystempersonnelonneurologicaloutcomeofoutofhospitalcardiacarrestwithnoncardiacetiology |