33 Systematic review of the effectiveness of prehospital critical care following out-of-hospital cardiac arrest

Vopelius-Feldt, Johannes von

doi:10.1136/emermed-2017-207308.33

Cited by 2 publications

(1 citation statement)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…18 However, according to Von Vopelius-Feldt the insufficient quality of the studies does not permit to draw conclusions. 19 It should be noted that our results cannot be compared with those of these different studies. Indeed, our results give insight into the debate on ALS utility, but they do not allow conclusions on the superiority of ALS or BLS.…”

Section: Discussionmentioning

confidence: 67%

Association between early advanced life support and good neurological outcome in out of hospital cardiac arrest: A propensity score analysis

Michelland

Adnet

Escutnaire

et al. 2019

Evaluation Clinical Practice

View full text Add to dashboard Cite

Background: Out-of-hospital cardiac arrest (OHCA) is an important public health problem. The French organization, combining OHCA basic life support (BLS) and advanced life support (ALS), has been recently questioned. The study was conducted to evaluate the association between early ALS (E-ALS) arrival and good neurological outcome at 1 month in nontraumatic OHCA patients. Materials and methods:Retrospective cohort study using data from RéAC, multicentre OHCA database since June 2011. Adult patients with nontraumatic cardiac arrest were identified, and firefighters' (BLS) arrival time was recorded. The main analysis was performed after multiple imputation, using propensity score matching with a variable ratio. Sensitivity analyses were also performed. The exposure was early ALS (E-ALS), start of ALS before. or simultaneously with BLS. The primary outcome was the cerebral performance category (CPC) at day 30 after the cardiac arrest (1-2 vs 3-5), while cumulative incidence of return of spontaneous circulation (ROSC) defined secondary outcomes. , a total of 30 672 adult nontraumatic OHCA with resuscitation were identified, from whom 20 804 were included, 2711 in the E-ALS group and 18 093 in the control group. Based on the matched sample, patients in the E-ALS group had a significantly lower rate of good neurological outcome than those in the control group (OR, 0.95; 95% CI, 0.93-0.96). Sensitivity analyses were mostly consistent with this result. Cumulative incidence of ROSC was higher in delayed ALS (D-ALS) group.Conclusions: This study showed that patients in the E-ALS group were less likely to have a good neurological outcome. One explanation of this unexpected result could be the total duration of resuscitation performed, which may be interrupted prematurely in cases of E-ALS.ABBREVIATIONS: ALS, advanced life support; ATT, treatment on the treated; BLS, basic life support; CPR, cardiopulmonary resuscitation; EAD, automated external defibrillator; IPTW, inverse probability of treatment weighting; MMT, mobile medical team; OHCA, out-of-hospital cardiac arrest.; ROSC, return of spontaneous circulation; SMD, standardized mean difference Laurianne Michelland is a clinician with a background in Health Sciences.

show abstract

Section: Discussionmentioning

confidence: 67%