• Dong Sun Choi, Taeyun Kim, Young Sun Ro, Ki Ok Ahn, Eui Jung Lee, Seung Sik Hwang, Sung Wook Song, Kyoung Jun Song, and Sang Do Shin.
• Dept. of Emergency Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro Bundang-gu, Seongnam 463-707, Republic of Korea. Electronic address: emergencychoi@gmail.com.
• Resuscitation. 2016 Feb 1; 99: 26-32.

BackgroundThe benefit of extracorporeal life support (ECLS) in highly selective patients with out-of-hospital cardiac arrest (OHCA) is supported by previous studies; however, it is unclear whether the effects of ECLS are observed at a population level. This study aimed to determine whether ECLS is associated with improved survival outcomes compared to conventional CPR (cardiopulmonary resuscitation) at a national level.MethodsWe used a Korean national OHCA cohort database from 2009 to 2013. The inclusion criteria were OHCA adults with presumed cardiac aetiology and resuscitation by emergency medical services (EMS). Patients were excluded if their information on prehospital time intervals or clinical outcomes at hospital discharge was incomplete or not captured. The primary outcome was neurologically favourable survival to discharge. We compared the primary outcomes between the ECLS and non-ECLS groups using a multivariable logistic regression and a propensity score matching analysis.ResultsOf the 119,077 patients with OHCA, 36,547 were included in the analysis. There were 320 patients who received ECLS. There was no significant difference in neurologically favourable survival to discharge between the ECLS group and the non-ECLS group after adjusting for covariates (adjusted OR, 0.65; 95% CI, 0.41-1.04). In the propensity score-matched cohort, there was also no significant difference between the two groups (adjusted OR, 0.94; 95% CI, 0.41-2.14).ConclusionsIn this propensity score-matched cohort using a nationwide OHCA database, OHCA victims who received ECLS did not show better survival outcomes than those who did not receive ECLS.Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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