• Mattias Bergström, Simon Schmidbauer, Johan Herlitz, Araz Rawshani, and Hans Friberg.
• Lund University, Skåne University Hospital, Department of Clinical Sciences, Intensive and Perioperative Care, Malmö, Sweden. Electronic address: matti_swe@hotmail.com.
• Resuscitation. 2018 Dec 1; 133: 147-152.

ObjectiveTo describe the prevalence, baseline characteristics and factors associated with survival in out-of-hospital cardiac arrest (OHCA) with initial non-shockable rhythm sub-grouped into pulseless electrical activity (PEA) and asystole as presenting rhythm.MethodsThe Swedish Registry of Cardiopulmonary Resuscitation is a prospectively recorded nationwide registry of modified Utstein parameters, including all patients with attempted resuscitation after OHCA. Data between 1990-2016 were analyzed.ResultsAfter exclusions, the study population consisted of 48,707 patients presenting with either PEA or asystole. The proportion of PEA increased from 12% to 22% during the study period with a fivefold increase in 30-day survival reaching 4.9%. Survival in asystole showed a modest increase from 0.6% to 1.3%. In the multivariable analysis, PEA was independently associated with survival at 30 days (OR 1.54, 95% CI 1.26-1.88).ConclusionBetween 1990 and 2016, the proportion of PEA as the first recorded rhythm doubled with a five-fold increase in 30-day survival, while survival among patients with asystole remained at low levels. PEA and asystole should be considered separate entities in clinical decision-making and be reported separately in observational studies and clinical trials.Copyright © 2018 Elsevier B.V. All rights reserved.

22 keywords...

hide…