Research Article

Conversion from Nonshockable to Shockable Rhythms and Out-of-Hospital Cardiac Arrest Outcomes by Initial Heart Rhythm and Rhythm Conversion Time

Table 1

OHCA patient characteristics overall, by initial rhythm, and by time of spontaneous shockable rhythm conversion.

VariableOverallInitial asystoleInitial pulseless electrical activity
No rhythm conversionSpontaneous rhythm conversionNo rhythm conversionSpontaneous rhythm conversion
TotalConversion in <10 minConversion in 10–15 minConversion in ≥15 minTotalConversion in <10 minConversion in 10–15 minConversion in ≥15 min

N24849139352581106156795366781655616330705
Median age, year (IQR)67 (55, 78)66 (54, 77)65 (54, 76)65 (55, 77)64 (55, 76)65 (53, 76)70 (59, 79)70 (58, 79)69 (56, 79)69 (59, 79)71 (60, 79)
Men, n (%)15344 (61.7)8498 (61.0)1726 (66.9)736 (69.4)383 (67.5)607 (63.7)4026 (60.3)1094 (66.1)435 (70.6)222 (67.3)437 (61.6)
Witnessed OHCA
 By EMS, n (%)2492 (10.0)601 (4.3)114 (4.4)46 (4.3)24 (4.2)44 (4.6)1479 (22.1)298 (18.0)112 (18.2)61 (18.5)125 (17.6)
 By bystander, n (%)7747 (31.2)3260 (23.4)889 (34.4)374 (35.2)200 (35.3)315 (33.1)2833 (42.4)765 (46.2)275 (44.6)158 (47.9)332 (46.8)
Bystander resuscitation, n (%)10738 (43.2)6280 (45.1)1147 (44.4)481 (45.3)254 (44.8)412 (43.2)2612 (39.1)699 (42.2)286 (46.4)139 (42.1)274 (38.6)
Public location, n (%)2426(9.8)1060 (7.6)301 (11.7)129 (12.2)73 (12.9)99 (10.4)802 (12.0)263 (15.9)125 (20.3)48 (14.5)90 (12.7)
Median EMS response time, min (IQR)5.4 (4.2, 6.9)5.3 (4.1, 6.8)5.5 (4.2, 7.0)5.5(4.3, 7.0)5.4 (4.1, 7.0)5.4 (4.1, 7.0)5.5 (4.2, 7.0)5.6 (4.3,7.0)5.6 (4.3, 7.0)5.5 (4.2, 7.0)5.7 (4.3, 7.0)
Median epinephrine use, mg (IQR)3 (3, 5)3(3, 4)4(3, 6)4(3, 5)4 (3, 5)4 (3, 6)3 (2, 4)4(3, 6)4 (3, 6)4 (3, 5)5(3, 6)
Advanced airway applied, n (%)21592 (86.9)11964 (85.9)2341 (90.7)933 (87.9)512 (90.3)896 (94.0)5807 (87.0)1480 (89.4)530 (86.0)289 (87.6)661 (93.2)
Median time of rhythm conversion, min (IQR)12.0 (6.7, 18.7)6.0 (3.9, 7.9)12.4 (11.2, 13.7)21.4 (17.9, 26.5)13.2 (7.0, 20.5)5.5 (3.1, 7.7)12.6 (11.1, 14.0)21.9 (18.4, 26.8)
Median time of rhythm conversion, min (IQR)12.0 (6.7, 18.7)6.0 (3.9, 7.9)12.4 (11.2, 13.7)21.4 (17.9, 26.5)13.2 (7.0, 20.5)5.5 (3.1, 7.7)12.6 (11.1, 14.0)21.9 (18.4, 26.8)

OHCA, out-of-hospital cardiac arrest; EMS, Emergency Medical Services; n, number; N, total number; IQR, interquartile range; min, minute; mg, milligram.