The association between scene time interval and neurologic outcome following adult bystander witnessed out-of-hospital cardiac arrest
To analyze the association between Emergency Medical Services (EMS) scene time interval (STI) and survival with functional neurologic recovery following adult out-of-hospital cardiac arrest (OHCA). A retrospective analysis of prospectively collected data from the national Cardiac Arrest Registry to...
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| Veröffentlicht in: | The American journal of emergency medicine 2021-08, Vol.46, p.628-633 |
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| creator | Coute, Ryan A. Nathanson, Brian H. Kurz, Michael C. McNally, Bryan Mader, Timothy J. |
| description | To analyze the association between Emergency Medical Services (EMS) scene time interval (STI) and survival with functional neurologic recovery following adult out-of-hospital cardiac arrest (OHCA).
A retrospective analysis of prospectively collected data from the national Cardiac Arrest Registry to Enhance Survival from January 2013 to December 2018. All adult non-traumatic, EMS-treated, bystander-witnessed OHCA with complete data were included. Patients with STI times >60 min, defined as the time from EMS arrival at the patient's side to the time the transport vehicle left the scene, unwitnessed OHCA, nursing home events, EMS-witnessed OHCA, or patients with termination of resuscitation in the field were excluded. The primary outcome was survival with functional recovery (Cerebral Performance Category [CPC] = 1 or 2). Multivariable logistic regression was used to quantify the association of STI with the primary.
outcome.
67,237 patients met inclusion criteria with 12,098 (18.0%) surviving with functional recovery. Mean STI (SD) for survivors with CPC 1 or 2 was 19 (8.4) and 22.8 (10.5) for those with poor outcomes (death or CPC 3–4; p |
| doi_str_mv | 10.1016/j.ajem.2020.11.059 |
| format | Article |
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A retrospective analysis of prospectively collected data from the national Cardiac Arrest Registry to Enhance Survival from January 2013 to December 2018. All adult non-traumatic, EMS-treated, bystander-witnessed OHCA with complete data were included. Patients with STI times >60 min, defined as the time from EMS arrival at the patient's side to the time the transport vehicle left the scene, unwitnessed OHCA, nursing home events, EMS-witnessed OHCA, or patients with termination of resuscitation in the field were excluded. The primary outcome was survival with functional recovery (Cerebral Performance Category [CPC] = 1 or 2). Multivariable logistic regression was used to quantify the association of STI with the primary.
outcome.
67,237 patients met inclusion criteria with 12,098 (18.0%) surviving with functional recovery. Mean STI (SD) for survivors with CPC 1 or 2 was 19 (8.4) and 22.8 (10.5) for those with poor outcomes (death or CPC 3–4; p < 0.001). For every 1-min increase in STI, the adjusted odds of a poor outcome increased by 3.5%; odds ratio = 1.035; 95% CI (1.027, 1.044); p < 0.001. Restricted cubic spline analysis showed increased risk of poor outcome after approximately 20 min.
Longer STI times are strongly associated with poor neurologic outcome in bystander-witnessed OHCA patients. After a STI duration of approximately 20 min, the associated risk of a poor neurologic outcome increased more rapidly.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2020.11.059</identifier><identifier>PMID: 33309248</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age ; Ambulance services ; Automation ; Cardiac arrest ; Cardiopulmonary resuscitation ; CPR ; Emergency medical care ; Emergency medical services ; Heart ; Heart attacks ; Information sharing ; Neurologic outcome ; Out-of-hospital cardiac arrest ; Patients ; Population ; Recovery of function ; Survival ; Variables</subject><ispartof>The American journal of emergency medicine, 2021-08, Vol.46, p.628-633</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><rights>2020. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-aea4822458be8b845eac233e032e6dc3d9958d6488b6d7cedd258207d530b65a3</citedby><cites>FETCH-LOGICAL-c384t-aea4822458be8b845eac233e032e6dc3d9958d6488b6d7cedd258207d530b65a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2555958049?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33309248$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Coute, Ryan A.</creatorcontrib><creatorcontrib>Nathanson, Brian H.</creatorcontrib><creatorcontrib>Kurz, Michael C.</creatorcontrib><creatorcontrib>McNally, Bryan</creatorcontrib><creatorcontrib>Mader, Timothy J.</creatorcontrib><creatorcontrib>The CARES Surveillance Group</creatorcontrib><creatorcontrib>CARES Surveillance Group</creatorcontrib><title>The association between scene time interval and neurologic outcome following adult bystander witnessed out-of-hospital cardiac arrest</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>To analyze the association between Emergency Medical Services (EMS) scene time interval (STI) and survival with functional neurologic recovery following adult out-of-hospital cardiac arrest (OHCA).
A retrospective analysis of prospectively collected data from the national Cardiac Arrest Registry to Enhance Survival from January 2013 to December 2018. All adult non-traumatic, EMS-treated, bystander-witnessed OHCA with complete data were included. Patients with STI times >60 min, defined as the time from EMS arrival at the patient's side to the time the transport vehicle left the scene, unwitnessed OHCA, nursing home events, EMS-witnessed OHCA, or patients with termination of resuscitation in the field were excluded. The primary outcome was survival with functional recovery (Cerebral Performance Category [CPC] = 1 or 2). Multivariable logistic regression was used to quantify the association of STI with the primary.
outcome.
67,237 patients met inclusion criteria with 12,098 (18.0%) surviving with functional recovery. Mean STI (SD) for survivors with CPC 1 or 2 was 19 (8.4) and 22.8 (10.5) for those with poor outcomes (death or CPC 3–4; p < 0.001). For every 1-min increase in STI, the adjusted odds of a poor outcome increased by 3.5%; odds ratio = 1.035; 95% CI (1.027, 1.044); p < 0.001. Restricted cubic spline analysis showed increased risk of poor outcome after approximately 20 min.
Longer STI times are strongly associated with poor neurologic outcome in bystander-witnessed OHCA patients. After a STI duration of approximately 20 min, the associated risk of a poor neurologic outcome increased more rapidly.</description><subject>Age</subject><subject>Ambulance services</subject><subject>Automation</subject><subject>Cardiac arrest</subject><subject>Cardiopulmonary resuscitation</subject><subject>CPR</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Information sharing</subject><subject>Neurologic outcome</subject><subject>Out-of-hospital cardiac arrest</subject><subject>Patients</subject><subject>Population</subject><subject>Recovery of function</subject><subject>Survival</subject><subject>Variables</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kbtqHDEUhkVIiNebvECKIEjjZja6zmjATTC-BAxunFpopLO2hhlpI2m8-AH83tGyjosUqQTSd_6jcz6EvlCyoYS238eNGWHeMMLqBd0Q2b9DKyo5axTt6Hu0Ih2XTdvJ7gSd5jwSQqmQ4iM64ZyTngm1Qi_3j4BNztF6U3wMeICyBwg4WwiAi58B-1AgPZkJm-BwgCXFKT54i-NSbKzv2zhNce_DAzZumQoennOpKCS89yVAzuAObBO3zWPMO19qlDXJeWOxSQly-YQ-bM2U4fPruUa_ri7vL26a27vrnxc_bhvLlSiNASMUY0KqAdSghARjGedAOIPWWe76XirXCqWG1nUWnGNSMdI5ycnQSsPX6OyYu0vx91Ib69nXQafJBIhL1kx0hNT8up81-vYPOsYlhfo7zaSUtRERfaXYkbIp5pxgq3fJzyY9a0r0QZIe9UGSPkjSlOoqqRZ9fY1ehhncW8lfKxU4PwJQd_HkIelsPYQ6kE9gi3bR_y__Dyo5pV0</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Coute, Ryan A.</creator><creator>Nathanson, Brian H.</creator><creator>Kurz, Michael C.</creator><creator>McNally, Bryan</creator><creator>Mader, Timothy J.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20210801</creationdate><title>The association between scene time interval and neurologic outcome following adult bystander witnessed out-of-hospital cardiac arrest</title><author>Coute, Ryan A. ; Nathanson, Brian H. ; Kurz, Michael C. ; McNally, Bryan ; Mader, Timothy J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-aea4822458be8b845eac233e032e6dc3d9958d6488b6d7cedd258207d530b65a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Ambulance services</topic><topic>Automation</topic><topic>Cardiac arrest</topic><topic>Cardiopulmonary resuscitation</topic><topic>CPR</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Information sharing</topic><topic>Neurologic outcome</topic><topic>Out-of-hospital cardiac arrest</topic><topic>Patients</topic><topic>Population</topic><topic>Recovery of function</topic><topic>Survival</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Coute, Ryan A.</creatorcontrib><creatorcontrib>Nathanson, Brian H.</creatorcontrib><creatorcontrib>Kurz, Michael C.</creatorcontrib><creatorcontrib>McNally, Bryan</creatorcontrib><creatorcontrib>Mader, Timothy J.</creatorcontrib><creatorcontrib>The CARES Surveillance Group</creatorcontrib><creatorcontrib>CARES Surveillance Group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Coute, Ryan A.</au><au>Nathanson, Brian H.</au><au>Kurz, Michael C.</au><au>McNally, Bryan</au><au>Mader, Timothy J.</au><aucorp>The CARES Surveillance Group</aucorp><aucorp>CARES Surveillance Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The association between scene time interval and neurologic outcome following adult bystander witnessed out-of-hospital cardiac arrest</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>46</volume><spage>628</spage><epage>633</epage><pages>628-633</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><abstract>To analyze the association between Emergency Medical Services (EMS) scene time interval (STI) and survival with functional neurologic recovery following adult out-of-hospital cardiac arrest (OHCA).
A retrospective analysis of prospectively collected data from the national Cardiac Arrest Registry to Enhance Survival from January 2013 to December 2018. All adult non-traumatic, EMS-treated, bystander-witnessed OHCA with complete data were included. Patients with STI times >60 min, defined as the time from EMS arrival at the patient's side to the time the transport vehicle left the scene, unwitnessed OHCA, nursing home events, EMS-witnessed OHCA, or patients with termination of resuscitation in the field were excluded. The primary outcome was survival with functional recovery (Cerebral Performance Category [CPC] = 1 or 2). Multivariable logistic regression was used to quantify the association of STI with the primary.
outcome.
67,237 patients met inclusion criteria with 12,098 (18.0%) surviving with functional recovery. Mean STI (SD) for survivors with CPC 1 or 2 was 19 (8.4) and 22.8 (10.5) for those with poor outcomes (death or CPC 3–4; p < 0.001). For every 1-min increase in STI, the adjusted odds of a poor outcome increased by 3.5%; odds ratio = 1.035; 95% CI (1.027, 1.044); p < 0.001. Restricted cubic spline analysis showed increased risk of poor outcome after approximately 20 min.
Longer STI times are strongly associated with poor neurologic outcome in bystander-witnessed OHCA patients. After a STI duration of approximately 20 min, the associated risk of a poor neurologic outcome increased more rapidly.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33309248</pmid><doi>10.1016/j.ajem.2020.11.059</doi><tpages>6</tpages></addata></record> |
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| subjects | Age Ambulance services Automation Cardiac arrest Cardiopulmonary resuscitation CPR Emergency medical care Emergency medical services Heart Heart attacks Information sharing Neurologic outcome Out-of-hospital cardiac arrest Patients Population Recovery of function Survival Variables |
| title | The association between scene time interval and neurologic outcome following adult bystander witnessed out-of-hospital cardiac arrest |
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