Factors Influencing Physician Decision Making to Attempt Advanced Resuscitation in Asystolic Out-of-Hospital Cardiac Arrest

Bibliographic Data

ID15470451
AuthorsCharles Payot (0000-0002-0284-4691, University Hospital of Geneva), Christophe A Fehlmann (0000-0002-4163-0338, University of Ottawa), Laurent Suppan (0000-0001-6989-6421, University Hospital of Geneva), Marc Niquille (0000-0002-2671-6889, University Hospital of Geneva), Christelle Lardi (0000-0003-3886-2821, University Centre of Legal Medicine), François Sarasin (0000-0002-1169-8526, University Hospital of Geneva), François P Sarasin (Division of Emergency Medicine, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, 1211 Geneva, Switzerland), Robert Larribau (0000-0002-5200-4199, University Hospital of Geneva, corresponding author)
Year2021
Volume18
Issue16
Pages8323-8323
Publication date2021-08-06
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph18168323
PMID34444071
OpenAlexW3188406238
LanguageEN
References cited40

The objective of this study was to identify the key elements used by prehospital emergency physicians (EP) to decide whether or not to attempt advanced life support (ALS) in asystolic out-of-hospital cardiac arrest (OHCA). From 1 January 2009 to 1 January 2017, all adult victims of asystolic OHCA in Geneva, Switzerland, were retrospectively included. Patients with signs of "obvious death" or with a Do-Not-Attempt-Resuscitation order were excluded. Patients were categorized as having received ALS if this was mentioned in the medical record, or, failing that, if at least one dose of adrenaline had been administered during cardiopulmonary resuscitation (CPR). Prognostic factors known at the time of EP's decision were included in a multivariable logistic regression model. Included were 784 patients. Factors favourably influencing the decision to provide ALS were witnessed OHCA (OR = 2.14, 95% CI: 1.43-3.20) and bystander CPR (OR = 4.10, 95% CI: 2.28-7.39). Traumatic aetiology (OR = 0.04, 95% CI: 0.02-0.08), age > 80 years (OR = 0.14, 95% CI: 0.09-0.24) and a Charlson comorbidity index greater than 5 (OR = 0.12, 95% CI: 0.06-0.27) were the factors most strongly associated with the decision not to attempt ALS. Factors influencing the EP's decision to attempt ALS in asystolic OHCA are the relatively young age of the patients, few comorbidities, presumed medical aetiology, witnessed OHCA and bystander CPR

Cardiopulmonary resuscitation · Comorbidity · Etiology · Intensive care medicine · Logistic regression · Resuscitation · Retrospective cohort study · Cardiac Arrest and Resuscitation · Emergency and Acute Care Studies · Medicine · Trauma and Emergency Care Studies · Emergency Medical Services · Emergency Medicine · Internal Medicine

Tools

Open DOIOpen Access