Acute cardiac care & resuscitation
A retrospective ‘target trial emulation’ comparing amiodarone and lidocaine for adult out-of-hospital cardiac arrest resuscitation
Main finding · Prehospital ROSCResult — go to the resultAdjusted odds ratio 1.29 CI 1.16–1.44Authors' conclusion
Our 'target trial emulation' suggested that lidocaine was associated with greater odds of prehospital ROSC in comparison to amiodarone when administered during resuscitation from shock refractory or recurrent VF/VT.
Study context
- Population
- Adult, non-traumatic out-of-hospital cardiac arrest (OHCA) patients in the ESO Data Collaborative 2018–2023 datasets who experienced OHCA prior to EMS arrival, presented with a shockable rhythm, and received amiodarone or lidocaine during resuscitationpatients from 1,707 EMS agencies eligible for analysis, 2,976 matched pairs
- Participants
- 23,263 participants
- Exposure
- Lidocaine vs amiodarone during resuscitation
- Lidocainen = 2,979
- Amiodaronen = 20,284reference
- Outcome
- Prehospital return of spontaneous circulation (ROSC)
Methodological detailspropensity score matching (PSM)
- Propensity score matching (PSM)
Main finding
As reported in the abstract
Adjusted odds ratio
1.29
CI 1.16–1.44
By group
Lidocaine
36.0
%
Amiodarone
30.4%
Lidocainevs amiodarone
aOR 1.29 (CI 1.16–1.44)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Lidocaine | Amiodarone | OR (CI) | |
|---|---|---|---|---|
| Survival to hospital dischargen = 538 pairs | 35.1 % | 25.7% | 1.54 (1.19–2.00) | |
| 0.512Odds ratio (log scale) |
| Outcome | Lidocaine | Amiodarone | P value |
|---|---|---|---|
| Number of post-drug defibrillationsFewer with lidocaine; n = 2,976 pairs · median | 2 (range 0–4) | 2 (range 0–6) | P < 0.01 |
| Mean | 3.3 | 3.9 |
Original publication
A retrospective ‘target trial emulation’ comparing amiodarone and lidocaine for adult out-of-hospital cardiac arrest resuscitation. Resuscitation. Published 23 January 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →