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Pulseless electrical activity is associated with improved survival in out-of-hospital cardiac arrest with initial non-shockable rhythm.
Lund University.
Lund University.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0003-4139-6235
University of Gothenburg.
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2018 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 133, p. 147-152, article id S0300-9572(18)31010-4Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2018. Vol. 133, p. 147-152, article id S0300-9572(18)31010-4
Keywords [en]
Asystole, Cardiac arrest, Non-shockable rhythm, Out-of-hospital cardiac arrest, Outcome, Pulseless electrical activity
National Category
Anesthesiology and Intensive Care
Research subject
Människan i vården
Identifiers
URN: urn:nbn:se:hb:diva-15530DOI: 10.1016/j.resuscitation.2018.10.018ISI: 000451022200033PubMedID: 30352246Scopus ID: 2-s2.0-85055332105OAI: oai:DiVA.org:hb-15530DiVA, id: diva2:1273258
Available from: 2018-12-20 Created: 2018-12-20 Last updated: 2018-12-20Bibliographically approved

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