• Am. J. Med. Sci. · Aug 2019

    Observational Study

    Association Between Time to Defibrillation and Neurologic Outcome in Patients With In-Hospital Cardiac Arrest.

    • Jin-Young Kang, Youn-Jung Kim, Yu Jung Shin, Jin Won Huh, Sang-Bum Hong, and Won Young Kim.
    • Department of Emergency Medicine and.
    • Am. J. Med. Sci. 2019 Aug 1; 358 (2): 143-148.

    BackgroundThe influence of time to defibrillation in patients with shockable in-hospital cardiac arrest (IHCA) has not been fully assessed. This study investigated the association between time to defibrillation and neurologic outcome in shockable IHCA survivors.Materials And MethodsA 7-year retrospective cohort study was conducted using a prospectively collected registry of adult IHCA patients. Patients whose first documented rhythm was pulseless ventricular tachycardia or ventricular fibrillation and who received defibrillation within 5 minutes were included.ResultsAmong 1,683 IHCA patients, 261 patients were included. At 28 days, a good neurologic outcome (Cerebral Performance Category score 1 or 2) according to time to defibrillation was seen in 49.0%, 21.1%, 13.4% and 16.5% of patients treated at <2 minutes (n = 128), 2-3 minutes (n = 55), 3-4 minutes (n = 35) and 4-5 minutes (n = 43) after IHCA, respectively. After adjusting for clinical characteristics, a graded inverse association was found after 3 minutes.ConclusionsA graded inverse association between time to defibrillation and neurologic outcome was observed beyond 3 minutes following cardiac arrest. A target time to defibrillation of <3 minutes may be a practical target goal in resource-limited hospitals.Copyright © 2019 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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