Year: 2025
Type: article
Study design: Observational Study
Abstract: A significant number of out-of-hospital cardiac arrest (OHCA) patients experience refractory ventricular arrhythmias despite prompt defibrillation. These refractory arrhythmias are associated with poor clinical outcomes, underscoring the need to investigate improved management strategies. Therefore, this study aimed to identify factors associated with shock-refractory OHCA during the prehospital stages of resuscitation. This multicenter observational study included adult OHCA patients (age ≥ 18 years) from October 2015 to June 2022 who required at least one prehospital defibrillation. This study's primary endpoint was shock-refractory OHCA, defined as three defibrillation shocks during resuscitation. A logistic regression analysis was performed to identify factors associated with shock-refractory OHCA. Among the 4320 patients included, 1961 (45.4%) experienced shock-refractory OHCA. Male sex (adjusted odds ratio [aOR], 1.423; 95% confidence interval [CI], 1.209-1.676), bystander automated external defibrillator (AED) shock (OR 2.350; 95% CI 1.426-3.968), and initial shockable rhythm (OR 1.739; 95% CI 1.490-2.030) were associated with a high risk of shock-refractory, while old age (OR 0.993; 95% CI 0.989-0.998) and receive bystander cardiopulmonary resuscitation (CPR) (OR 0.829; 95% CI 0.718-0.958) were associated with a low risk of shock-refractory OHCA. This study showed that the prehospital factors of age, sex, initial rhythm, AED shock source, and absence of bystander CPR were associated with shock-refractory OHCA.
Source: Scientific Reports
Authors: Kyung Hun Yoo, Byuk Sung Ko, Won Young Kim, Tae Ho Lim, Hyunggoo Kang, Jaehoon Oh, Juncheol Lee, Sang Kuk Han, Phil Cho Choi, Young Hwan Lee, Sang O. Park, Jong Seok Lee, Ki Young Jeong, Sung Hyuk Choi, Young Hoon Yoon, Su Jin Kim, Kap Su Han, Min Seob Sim, Gun Tak Lee, Youn Jung Kim, Youn Jung Kim, Jong Whan Shin, Hui Jai Lee, Keun Hong Park, Hahn Bom Kim, Yoo Seok Park, Arom Choi, Tae Young Kong, Hyuna Hwang, Youngsuk Cho, Gu Hyun Kang, Yong Soo Jang, Sung Wook Park, Wook Tae Yang, Hyun Wook Ryu, Jae Yun Ahn, Hyuk Jun Yang, Jae-hyug Woo, Sung Hyun Yun, Chong Sun Kim, Sun Pyo Kim, Jin Woong Lee, Wonjoon Jeong, Sung Soo Park, Jae Kwang Lee, Ryeok Ahn, Wook Jin Choi, Bang Shill Rhee, You Hwan Jo, Sung Min Park, In Byung Kim, Ki Ok Ahn, Se Joong Ahn, Seung Cheol Lee, Sang Hun Lee, Kyeong Min Lee, Young Sik Kim, Young Sik Kim, Jin Sik Park, Myung Hee Park, Dai Han Wi, Jin Kun Bae, Yong Hee Lee, Sang Ook Ha, Won Seok Yang, Ju Ok Park, Hang A. Park, Kyoung Chul Cha, Woo Jin Jung, Taek Geun Ohk, Myoung Cheol Shin, An Mu Eob, Kyung Sook Park, Sang Chul Kim, Gwan Jin Park, Han Joo Choi, Yong Oh Kim, Yong Oh Kim, Tae Oh Jung, Jae Chol Yoon, Young Tae Park, Ju Taek Lee, Jin Hee Jeong, Sang Bong Lee, Won Kim, Yi Sang Moon, Sung Wook Song, Seo Young Ko, Joon-myoung Kwon, Eui Hyuk Kang, Sang Chan Jin, Tae-kwon Kim, Chang Sun Kim, Hyun Goo Shin, Dong Sun Choi, Chul Min Ha, Jai Woog Ko, Yun Jeong Hwang, Sung Phil Chung, Kyung Jun Song, Sang Hoon Na, Gyu Chong Cho, Seung Sik Hwang, Sung Oh Hwang, Sang Do Shin, Hyuk Jun Yang, Jeong Ho Park, Jong Hak Park, Jin Hee Jung, Kyoung Chul Cha, Ji Hoon Kim, Yeongho Choi, Seulki Choi, Se Jin Lee, Hye Jee Joo
Institutions: Hanyang University, Asan Medical Center, University of Ulsan, Hanyang University Seoul Hospital, Seoul National University Hospital, Kyung Hee University, Konyang University Hospital, Chungnam National University Hospital, Dongguk University Gyeongju Hospital, Kangbuk Samsung Hospital, Konkuk University Medical Center, CHA University Bundang Medical Center, Seoul National University Bundang Hospital, Pusan National University Hospital, Korea University Guro Hospital, Chungbuk National University, Chosun University Hospital, Chungbuk National University Hospital, Korea University Anam Hospital, Samsung Medical Center, Bundang Jesaeng Hospital, Dankook University Hospital, Seoul National University, SNUH SMG-SNU Boramae Medical Center, Seoul Medical Center, Hallym University Chuncheon Sacred Heart Hospital, Yonsei University, Severance Hospital, Gangnam Severance Hospital, Hallym University, Kangdong Sacred Heart Hospital, Hallym University Kangnam Sacred Heart Hospital, Kyungpook National University Hospital, Hallym University Sacred Heart Hospital, Gachon University Gil Medical Center, Korea University Ansan Hospital, Catholic Kwandong University International St. Mary's Hospital, Hanyang University Guri Hospital, Ulsan University Hospital, Ajou University Hospital, Myongji Hospital, Dongguk University Ilsan Hospital, Gyeongsang National University Hospital, Sejong General Hospital, Hallym University Dongtan Sacred Heart Hospital, Wonkwang University Sanbon Hospital, Wonju Severance Christian Hospital, Kangwon National University Hospital, Jeonbuk National University Hospital, Cheju Halla General Hospital, Jeju National University Hospital, Incheon International Airport Corporation (South Korea), Keimyung University Dongsan Medical Center, Keimyung University Dongsan Hospital, Eulji University, Eulji University Uijeongbu Eulji Medical Center, Hanil General Hospital, Yongin Severance Hospital, Yonsei University Health System
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,690
OpenAlex ID: W4413313870