Acute cardiac care & resuscitationCohort study
Naloxone administration associated with improved survival in PEA out-of-hospital cardiac arrests
- retrospective cohort study
- adjusted propensity-score matching
- logistic regression
- national cohort
Authors' conclusion
In this national cohort, naloxone administration was associated with improved survival to hospital discharge for OHCA patients in PEA. No association was found between naloxone and clinical outcomes for OHCA patients with shockable rhythms or asystole. Prospective, randomized trials are needed to assess for true causality.
Study context
- Population
- Patients with out-of-hospital cardiac arrest in the ESO Data Collaborative, 2019–2020, stratified by presenting rhythm (shockable rhythm, PEA, asystole)cases analyzed, 7567 (18.8%) received naloxone
- Participants
- 40,333 patients
- Exposure
- received naloxone vs no naloxone
- received naloxonen = 7,567
Main finding
As reported in the abstract
Prehospital ROSC and survival to hospital discharge, overall · before matching
rate of prehospital ROSC
21.5%
survival to hospital discharge
9.0%
Observational data: associations, not effects.
Further findings
Prehospital ROSC, patients in PEA
| Comparison | OR (95% CI) | |
|---|---|---|
| received naloxone · similar rates of ROSC · after propensity score matching | 1.09 (0.90–1.31) | |
| 0.512Odds ratio (log scale) |
Survival to hospital discharge, patients in PEA
| Comparison | OR (95% CI) | |
|---|---|---|
| received naloxone · higher survival · after propensity score matching | 1.46 (1.11–1.92) | |
| 0.512Odds ratio (log scale) |
ROSC and survival, shockable rhythms or asystole
- Naloxone administration was not associated with differences in either outcome
Original publication
Naloxone administration associated with improved survival in PEA out-of-hospital cardiac arrests. Resuscitation. Published 22 May 2026. doi:10.1016/j.resuscitation.2026.111139
Summarised from the published abstract; every number is checked against it