Delayed arrival of advanced life support adversely affects the neurological outcome in a multi-tier emergency response system
Prehospital management of out-of-hospital cardiac arrest (OHCA) is based on basic life support, with the addition of advanced life support (ALS) if possible. This study aimed to investigate the effect of delayed arrival of ALS on neurological outcomes of patients with OHCA at hospital discharge. Thi...
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| Veröffentlicht in: | The American journal of emergency medicine 2023-09, Vol.71, p.1-6 |
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| container_title | The American journal of emergency medicine |
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| creator | Yang, Hae Chul Park, Seung Min Lee, Kui Ja Jo, You Hwan Kim, Yu Jin Lee, Dong Keon Jang, Dong-Hyun |
| description | Prehospital management of out-of-hospital cardiac arrest (OHCA) is based on basic life support, with the addition of advanced life support (ALS) if possible. This study aimed to investigate the effect of delayed arrival of ALS on neurological outcomes of patients with OHCA at hospital discharge.
This was a retrospective study of a registry of patients with OHCA. A multi-tier emergency response system was established in the study area. ALS was initiated when the second-arrival team arrived at the scene. A restricted cubic spline curve was used to investigate the relationship between the response time interval of the second-arrival team and neurological outcomes at hospital discharge. Multivariable logistic regression analysis was performed to assess the independent association between the response time interval of the second-arrival team and neurological outcomes of patients at hospital discharge.
A total of 3186 adult OHCA patients who received ALS at the scene were included in the final analysis. A restricted cubic spline curve showed that a long response time interval of the second-arrival team was correlated with a high likelihood of poor neurological outcomes. Meanwhile, multivariable logistic regression analysis showed that a long response time interval of the second-arrival team was independently associated with poor neurological outcomes (odds ratio, 1.10; 95% confidence interval, 1.03–1.17).
In a multi-tiered prehospital emergency response system, the delayed arrival of ALS was associated with poor neurological outcomes at hospital discharge. |
| doi_str_mv | 10.1016/j.ajem.2023.06.001 |
| format | Article |
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This was a retrospective study of a registry of patients with OHCA. A multi-tier emergency response system was established in the study area. ALS was initiated when the second-arrival team arrived at the scene. A restricted cubic spline curve was used to investigate the relationship between the response time interval of the second-arrival team and neurological outcomes at hospital discharge. Multivariable logistic regression analysis was performed to assess the independent association between the response time interval of the second-arrival team and neurological outcomes of patients at hospital discharge.
A total of 3186 adult OHCA patients who received ALS at the scene were included in the final analysis. A restricted cubic spline curve showed that a long response time interval of the second-arrival team was correlated with a high likelihood of poor neurological outcomes. Meanwhile, multivariable logistic regression analysis showed that a long response time interval of the second-arrival team was independently associated with poor neurological outcomes (odds ratio, 1.10; 95% confidence interval, 1.03–1.17).
In a multi-tiered prehospital emergency response system, the delayed arrival of ALS was associated with poor neurological outcomes at hospital discharge.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2023.06.001</identifier><identifier>PMID: 37315438</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Advanced Cardiac Life Support ; Advanced life support ; Amyotrophic lateral sclerosis ; Cardiac arrest ; Cardiopulmonary resuscitation ; CPR ; Drug administration ; Electric Countershock ; Emergency communications systems ; Emergency medical care ; Emergency medical service ; Emergency Medical Services ; Emergency preparedness ; Humans ; Medical prognosis ; Out-of-hospital cardiac arrest ; Out-of-Hospital Cardiac Arrest - therapy ; Paramedics ; Patients ; Regression analysis ; Response time ; Retrospective Studies ; Teams</subject><ispartof>The American journal of emergency medicine, 2023-09, Vol.71, p.1-6</ispartof><rights>2023 Elsevier Inc.</rights><rights>Copyright © 2023 Elsevier Inc. All rights reserved.</rights><rights>2023. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-4742c81e3c4544687d01346f002307f0ba7b804dcf96c611007470db5b3026343</citedby><cites>FETCH-LOGICAL-c384t-4742c81e3c4544687d01346f002307f0ba7b804dcf96c611007470db5b3026343</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0735675723002978$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37315438$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Hae Chul</creatorcontrib><creatorcontrib>Park, Seung Min</creatorcontrib><creatorcontrib>Lee, Kui Ja</creatorcontrib><creatorcontrib>Jo, You Hwan</creatorcontrib><creatorcontrib>Kim, Yu Jin</creatorcontrib><creatorcontrib>Lee, Dong Keon</creatorcontrib><creatorcontrib>Jang, Dong-Hyun</creatorcontrib><title>Delayed arrival of advanced life support adversely affects the neurological outcome in a multi-tier emergency response system</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>Prehospital management of out-of-hospital cardiac arrest (OHCA) is based on basic life support, with the addition of advanced life support (ALS) if possible. This study aimed to investigate the effect of delayed arrival of ALS on neurological outcomes of patients with OHCA at hospital discharge.
This was a retrospective study of a registry of patients with OHCA. A multi-tier emergency response system was established in the study area. ALS was initiated when the second-arrival team arrived at the scene. A restricted cubic spline curve was used to investigate the relationship between the response time interval of the second-arrival team and neurological outcomes at hospital discharge. Multivariable logistic regression analysis was performed to assess the independent association between the response time interval of the second-arrival team and neurological outcomes of patients at hospital discharge.
A total of 3186 adult OHCA patients who received ALS at the scene were included in the final analysis. A restricted cubic spline curve showed that a long response time interval of the second-arrival team was correlated with a high likelihood of poor neurological outcomes. Meanwhile, multivariable logistic regression analysis showed that a long response time interval of the second-arrival team was independently associated with poor neurological outcomes (odds ratio, 1.10; 95% confidence interval, 1.03–1.17).
In a multi-tiered prehospital emergency response system, the delayed arrival of ALS was associated with poor neurological outcomes at hospital discharge.</description><subject>Adult</subject><subject>Advanced Cardiac Life Support</subject><subject>Advanced life support</subject><subject>Amyotrophic lateral sclerosis</subject><subject>Cardiac arrest</subject><subject>Cardiopulmonary resuscitation</subject><subject>CPR</subject><subject>Drug administration</subject><subject>Electric Countershock</subject><subject>Emergency communications systems</subject><subject>Emergency medical care</subject><subject>Emergency medical service</subject><subject>Emergency Medical Services</subject><subject>Emergency preparedness</subject><subject>Humans</subject><subject>Medical prognosis</subject><subject>Out-of-hospital cardiac arrest</subject><subject>Out-of-Hospital Cardiac Arrest - therapy</subject><subject>Paramedics</subject><subject>Patients</subject><subject>Regression analysis</subject><subject>Response time</subject><subject>Retrospective Studies</subject><subject>Teams</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kT9v1TAUxS1ERR-FL8CALLGwJPW_2KnEglooSJW6wGw5zk1x5MTBdp6Uod8dR68wMHS60tXvHN17DkLvKKkpofJyrM0IU80I4zWRNSH0BTrQhrOqpYq-RAeieFNJ1ahz9DqlsQBUNOIVOueK00bw9oAeb8CbDXpsYnRH43EYsOmPZrZl590AOK3LEmLetxAT-A2bYQCbE86_AM-wxuDDg7O7ds02TIDdjA2eVp9dlR1EDBPEB5jthiOkJcypuG4pw_QGnQ3GJ3j7NC_Qz69fflx_q-7ub79ff76rLG9FroQSzLYUuC3nC9mqnlAu5EDK50QNpDOqa4no7XAlraSUECUU6bum44RJLvgF-njyXWL4vULKenLJgvdmhrAmzVomGZWsoQX98B86hjXO5bpCiYaKK9HuFDtRNoaUIgx6iW4ycdOU6L0cPeq9HL2Xo4nUJfsiev9kvXYT9P8kf9sowKcTACWLY0lOJ-tgr8LFkrjug3vO_w-2iqAy</recordid><startdate>202309</startdate><enddate>202309</enddate><creator>Yang, Hae Chul</creator><creator>Park, Seung Min</creator><creator>Lee, Kui Ja</creator><creator>Jo, You Hwan</creator><creator>Kim, Yu Jin</creator><creator>Lee, Dong Keon</creator><creator>Jang, Dong-Hyun</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><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>AEUYN</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>202309</creationdate><title>Delayed arrival of advanced life support adversely affects the neurological outcome in a multi-tier emergency response system</title><author>Yang, Hae Chul ; Park, Seung Min ; Lee, Kui Ja ; Jo, You Hwan ; Kim, Yu Jin ; Lee, Dong Keon ; Jang, Dong-Hyun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-4742c81e3c4544687d01346f002307f0ba7b804dcf96c611007470db5b3026343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Advanced Cardiac Life Support</topic><topic>Advanced life support</topic><topic>Amyotrophic lateral sclerosis</topic><topic>Cardiac arrest</topic><topic>Cardiopulmonary resuscitation</topic><topic>CPR</topic><topic>Drug administration</topic><topic>Electric Countershock</topic><topic>Emergency communications systems</topic><topic>Emergency medical care</topic><topic>Emergency medical service</topic><topic>Emergency Medical Services</topic><topic>Emergency preparedness</topic><topic>Humans</topic><topic>Medical prognosis</topic><topic>Out-of-hospital cardiac arrest</topic><topic>Out-of-Hospital Cardiac Arrest - therapy</topic><topic>Paramedics</topic><topic>Patients</topic><topic>Regression analysis</topic><topic>Response time</topic><topic>Retrospective Studies</topic><topic>Teams</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Hae Chul</creatorcontrib><creatorcontrib>Park, Seung Min</creatorcontrib><creatorcontrib>Lee, Kui Ja</creatorcontrib><creatorcontrib>Jo, You Hwan</creatorcontrib><creatorcontrib>Kim, Yu Jin</creatorcontrib><creatorcontrib>Lee, Dong Keon</creatorcontrib><creatorcontrib>Jang, Dong-Hyun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><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 One Sustainability</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>Yang, Hae Chul</au><au>Park, Seung Min</au><au>Lee, Kui Ja</au><au>Jo, You Hwan</au><au>Kim, Yu Jin</au><au>Lee, Dong Keon</au><au>Jang, Dong-Hyun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Delayed arrival of advanced life support adversely affects the neurological outcome in a multi-tier emergency response system</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>2023-09</date><risdate>2023</risdate><volume>71</volume><spage>1</spage><epage>6</epage><pages>1-6</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><abstract>Prehospital management of out-of-hospital cardiac arrest (OHCA) is based on basic life support, with the addition of advanced life support (ALS) if possible. This study aimed to investigate the effect of delayed arrival of ALS on neurological outcomes of patients with OHCA at hospital discharge.
This was a retrospective study of a registry of patients with OHCA. A multi-tier emergency response system was established in the study area. ALS was initiated when the second-arrival team arrived at the scene. A restricted cubic spline curve was used to investigate the relationship between the response time interval of the second-arrival team and neurological outcomes at hospital discharge. Multivariable logistic regression analysis was performed to assess the independent association between the response time interval of the second-arrival team and neurological outcomes of patients at hospital discharge.
A total of 3186 adult OHCA patients who received ALS at the scene were included in the final analysis. A restricted cubic spline curve showed that a long response time interval of the second-arrival team was correlated with a high likelihood of poor neurological outcomes. Meanwhile, multivariable logistic regression analysis showed that a long response time interval of the second-arrival team was independently associated with poor neurological outcomes (odds ratio, 1.10; 95% confidence interval, 1.03–1.17).
In a multi-tiered prehospital emergency response system, the delayed arrival of ALS was associated with poor neurological outcomes at hospital discharge.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37315438</pmid><doi>10.1016/j.ajem.2023.06.001</doi><tpages>6</tpages></addata></record> |
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| ispartof | The American journal of emergency medicine, 2023-09, Vol.71, p.1-6 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adult Advanced Cardiac Life Support Advanced life support Amyotrophic lateral sclerosis Cardiac arrest Cardiopulmonary resuscitation CPR Drug administration Electric Countershock Emergency communications systems Emergency medical care Emergency medical service Emergency Medical Services Emergency preparedness Humans Medical prognosis Out-of-hospital cardiac arrest Out-of-Hospital Cardiac Arrest - therapy Paramedics Patients Regression analysis Response time Retrospective Studies Teams |
| title | Delayed arrival of advanced life support adversely affects the neurological outcome in a multi-tier emergency response system |
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