Acute cardiac care & resuscitation
Evaluating the accuracy of surrogate markers for identifying opioid-associated out-of-hospital cardiac arrests
Authors' conclusion
EMS naloxone administration and EMS- impression overdose had limited sensitivity for identifying OA-OHCA in expired patients in this large urban EMS system. Prehospital and public health researchers should identify improved methods for accurately classifying this OHCA subpopulation.
Study context
- Population
- Adult (≥18) non-traumatic OHCA patients treated by Milwaukee County emergency medical services (EMS) between January 1st, 2015 to December 31st, 2016 who expiredOHCA cases included
- Participants
- 1,654 participants
- Exposure
- EMS naloxone administration and EMS-impression overdose as surrogate markers against Milwaukee County Medical Examiner (MCME) opioid toxicology data as the reference standard
- Received ≥1 Naloxonen = 112
- No Naloxonen = 1,542
- EMS-impression overdosen = 60
- Not EMS-impression overdosen = 1,594
- Outcome
- OA-OHCA cases among opioid-associated deaths in the MCME Drug-related Death Database
Main finding
As reported in the abstract
Opioid-associated deaths in the MCME Drug-related Death Database
525
Of the 525 opioid-associated deaths, OA-OHCA cases treated by EMS
150
28.6%
Observational data: associations, not effects.
Further findings
| Outcome | Received ≥1 Naloxone | EMS-impression overdose |
|---|---|---|
| Accuracy for identifying OA-OHCA | ||
| SN | 39% | 27% |
| SP | 96% | 99% |
| PPV | 52% | 68% |
| NPV | 94% | 93% |
Original publication
Evaluating the accuracy of surrogate markers for identifying opioid-associated out-of-hospital cardiac arrests. Resuscitation. Published 5 March 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →