Acute cardiac care & resuscitation
Incidence and outcomes of out-of-hospital cardiac arrest from initial asystole: a systematic review and meta-analysis
Authors' conclusion
Initial asystolic OHCA made up 53% of all EMS-treated patients and pooled survival rates were extremely poor. Research efforts in this population should focus on developing prevention strategies as well as adherence to termination or withholding of resuscitation guidelines for asystolic OHCA.
Study context
- Population
- Emergency Medical Services (EMS) attended and treated out-of-hospital cardiac arrest (OHCA) from initial asystole, studies between 1990 and August 2024EMS-treated patients, 82 studies across 35 countries · EMS attended populations (5 studies) 35,561
- Participants
- 540,054 participants
- Outcome
- Survival to hospital discharge or 30-days
- Follow-up
- hospital discharge or 30-days
Methodological detailsrandom-effects models, meta-regression
- Random-effects models
- Meta-regression
Pooled result
As reported in the abstract
Overall pooled proportion of survivors
1.5%
95% CI 1.2%, 1.8%, I2 = 97%
Further pooled results
Proportion of EMS-treated OHCA with initial asystole
- Pooled proportion
- 53.0% (95% CI: 49.0%, 58.0%; I2 = 100%)
Event survival
- Pooled proportion
- 11.6% (95% CI 6.5%, 17.8%, I2 = 99%)
Prehospital ROSC
- Pooled proportion
- 16.0% (95% CI 14.0%, 17.0%, I2 = 100%)
Neurologically favourable survival · longest follow-up
- Pooled proportion
- 0.6% (95% CI 0.5%, 0.8%, I2 = 100%)
Incidence of EMS-treated asystolic OHCA
- Overall pooled incidence
- 11.0 cases per 100,000 person-years (95% CI: 10.5, 11.5, I2 = 100%)
Factors associated with survival to hospital discharge or 30-days
- Stratified analysis: population type, study duration, study design and aetiology significantly associated
- Adjusted analysis: population type, study duration, highest EMS skill level and region significantly associated
Sources of variation in incidence (multivariable analysis)
- Study region, arrest aetiology, sample size, year of publication, study population, study duration and study quality significantly explained variation
Heterogeneity
- High clinical and statistical heterogeneity
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →