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Influence of advanced life support response time on out-of-hospital cardiac arrest patient outcomes in Taipei

Chen, Hsuan-An ; Hsu, Shuo-Ting ; Hsieh, Ming-Ju ; [et al.]

Public Library of Science (PLoS) ; 2022

In: PLOS ONE Vol. 17, No. 4 ( 2022-4-14), p. e0266969-

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In: PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 4 ( 2022-4-14), p. e0266969-

Abstract: The association between out-of-hospital cardiac arrest patient survival and advanced life support response time remained controversial. We aimed to test the hypothesis that for adult, non-traumatic, out-of-hospital cardiac arrest patients, a shorter advanced life support response time is associated with a better chance of survival. We analyzed Utstein-based registry data on adult, non-traumatic, out-of-hospital cardiac arrest patients in Taipei from 2011 to 2015. Methods Patients without complete data, witnessed by emergency medical technicians, or with response times of ≥ 15 minutes, were excluded. We used logistic regression with an exposure of advanced life support response time. Primary and secondary outcomes were survival to hospital discharge and favorable neurological outcomes (cerebral performance category ≤ 2), respectively. Subgroup analyses were based on presenting rhythms of out-of-hospital cardiac arrest, bystander cardiopulmonary resuscitation, and witness status. Results A total of 4,278 cases were included in the final analysis. The median advanced life support response time was 9 minutes. For every minute delayed in advanced life support response time, the chance of survival to hospital discharge would reduce by 7% and chance of favorable neurological outcome by 9%. Subgroup analysis showed that a longer advanced life support response time was negatively associated with the chance of survival to hospital discharge among out-of-hospital cardiac arrest patients with shockable rhythm and pulse electrical activity groups. Conclusions In non-traumatic, adult, out-of-hospital cardiac arrest patients in Taipei, a longer advanced life support response time was associated with declining odds of survival to hospital discharge and favorable neurologic outcomes, especially in patients presenting with shockable rhythm and pulse electrical activity.

Type of Medium: Online Resource

ISSN: 1932-6203

URL: Article

DOI: 10.1371/journal.pone.0266969

DOI: 10.1371/journal.pone.0266969.g001

DOI: 10.1371/journal.pone.0266969.g002

DOI: 10.1371/journal.pone.0266969.g003

DOI: 10.1371/journal.pone.0266969.t001

DOI: 10.1371/journal.pone.0266969.t002

DOI: 10.1371/journal.pone.0266969.t003

DOI: 10.1371/journal.pone.0266969.s001

DOI: 10.1371/journal.pone.0266969.s002

Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2022

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The effect of the number and level of emergency medical technicians on patient outcomes following out of hospital cardiac arrest in Taipei

Sun, Jen-Tang ; Chiang, Wen-Chu ; Hsieh, Ming-Ju ; [et al.]

Elsevier BV ; 2018

In: Resuscitation Vol. 122 ( 2018-01), p. 48-53

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In: Resuscitation, Elsevier BV, Vol. 122 ( 2018-01), p. 48-53

Type of Medium: Online Resource

ISSN: 0300-9572

URL: Article

DOI: 10.1016/j.resuscitation.2017.11.048

Language: English

Publisher: Elsevier BV

Publication Date: 2018

detail.hit.zdb_id: 2010733-X

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Abstract 21340: The Effect of Number and Level of Emergency Medical Technicians on Patient Outcomes Following Out of Hospital Cardiac Arrest

Lam, Hio Cheng ; Sun, Jen-Tang ; Chiang, Wen-Chu ; [et al.]

Ovid Technologies (Wolters Kluwer Health) ; 2017

In: Circulation Vol. 136, No. suppl_1 ( 2017-11-14)

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In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 136, No. suppl_1 ( 2017-11-14)

Abstract: Introduction: The effect of on-scene number and level of emergency medical technicians (EMTs) on the outcome of patients with out-of-hospital cardiac arrest (OHCA) remains unclear. In Taipei city, the respond number of EMTs for an OHCA ranged from 2 to 6 and the levels included EMT-intermediate (EMT-I) and EMT-paramedic (EMT-P). Hypothesis: We tested the hypothesis that for adult, non-trauma OHCA patient, on-scene EMT number more than 2 or level of the EMT-P ratio 〉 50%, comparing to crews with two EMT-Is, would improve survival to hospital discharge. Methods: We analyzed five years of Utstein-based registry data on OHCA in Taipei. The eligible patients were non-traumatic adult OHCA with resuscitation attempts. The exposures were the total number of EMT or the EMT-P ratio 〉 50%. The outcome was survival to discharge. Subgroup analyses were based on Utstein template. Results: From 2011 to 2015, there were 8,262 cases included. The average of on-scene EMT number was 3.0 ± 1.0, and a total of 1085 (13.1%) OHCAs was approached by crews of EMT-P ratio 〉 50%. The overall cases of survival to discharge were 616 (7.5%). While the increase of one EMT on-scene was not associated with better chances of survival (adjusted odds ratio [aOR] 0.98; 95% confidence interval [CI] : 0.89-1.08), the level with the EMT-P ratio 〉 50% was associated with improved outcome (aOR 1.36; 95%CI: 1.06-1.76). Subgroup analyses showed that EMT-P 〉 50% significantly benefited the outcome in witnessed OHCAs with non-shockable rhythm (aOR 1.69; 95%CI: 1.01-2.58). Taking both number and level into consideration (figure) , the best survival to discharge occurred at 4 EMTs with the EMT-P ratio 〉 50% (aOR 2.54; 95%CI: 1.43-4.50) when compared to crews with two EMTs. Conclusions: On-scene EMT-P ratio 〉 50% was associated with improved survival to discharge of OHCAs, especially in those with witnessed, non-shockable rhythm. The presence of four EMTs with EMTP-ratio 〉 50% at the scene of OHCA was associated with the best outcome.

Type of Medium: Online Resource

ISSN: 0009-7322 , 1524-4539

URL: Article

DOI: 10.1161/circ.136.suppl_1.21340

Language: English

Publisher: Ovid Technologies (Wolters Kluwer Health)

Publication Date: 2017

detail.hit.zdb_id: 1466401-X

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